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Full text of "California Code of Regulations, (Vol. 31), Title 22, Social Security (Part 4)"

.A. 



Barclays Official 

California 

Code of 
Regulations 



Title 22. Social Security 



Complete Title 

(continued) 



Vol. 31 



THOIVISOM 

f^ 

\A/EST 



Barclays Official California Code of Regulations 

425 Market Street • Fourth Floor • San Francisco, CA 94105 
800-888-3600 



Barclays Official California Code Of Regulations 

REVISED edition 

This edition of Barclays Ojficial California Code of Regulations, revised on April 1, 1990, has been 
published under the direction of the California Office of Administrative Law which is solely respon- 
sible for its contents. Comments or questions regarding regulations published in this edition should 
be addressed to the State of California, Office of Administrative Law, 300 Capitol Mall, Suite 1250, 
Sacramento, CA 95814, (916) 323-6225. En^ors reported will be promptly corrected in subsequent 
supplements. 

OFFICIAL PUBLICATION 

Courts are required to take judicial notice of contents of regulations published in the Official Califor- 
nia Code of Regulations (Gov. Code, § 11344.6). Barclays Official California Code of Regulations, 
as revised April 1, 1990, has been certified by the Office of Administrative Law as the official publi- 
cation of the State of California for this purpose pursuant to title 1, California Code of Regulations, 
section 190. 

CODE SUPPLEMENTS 

Amendments to the official Code are certified weekly by the Office of Administrative Law for publi- 
cation by Barclays. These amendments, when certified and published, become part of the Official 
California Code of Regulations, beginning with Register 90, No. 14, dated April 7, 1990, and include 
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CODE CITATION 

Cite all materials in the Ojficial California Code of Regulations by title number and section number. 
Example: Title 3, California Code of Regulations, section 432 (Short form: Cal. Code Regs., tit. 3, 

§ 432). 

COPYRIGHT NOTICE 

© 2008, State of California. 

This material may not be commercially reproduced or sold in print or electronic forms without 

written permission of ThomsonAVest. 



Title 22 



Social Security 



Title Table of Contents 



Title 22. Social Security 

Table of Contents 



Division 1. 



Subdivision 1. 



Division 1. 



Part 1. 



Chapter 1. 


Article 1. 


Article 2. 


Chapter 2. 


Article 1. 


Article 3. 


Article 4. 


Chapter 3. 


Article 1. 


Article 1.5 


Article 2. 


Article 3. 


Article 4. 


Article 5. 



Article 6. 



Article 7. 



Chapter 4. 
Article 1. 
Article 2. 

Article 3. 
Article 4. 



Page 

Employment Development 
Department i 

Director of Employment 

Development 3 

Unemployment and Disability 
Compensation 3 

Unemployment Compensation 3 

General Provisions 3 

Policy and Interpretation 3 

General Definitions 3 

Administration 3 

Employment Development 
Department 3 

California Unemployment 

Insurance Appeals Board 9 

Interstate and Federal 

Cooperation 9 

Scope or Coverage 18 

Employment 18 

Employee 20 

Excluded Services 21 

Subject Employers 26 

Elective Coverage 26 

Elections for Financing 

Unemployment Insurance 

Coverage 31 

Financing Unemployment 

Insurance Coverage for 

Public School Employees 33 

Financing Unemployment 

Insurance Coverage for 

Local Public Entity 

Employees 33 

Contributions and Reports 34 

Definitions 34 

"Wages" the Basis of the 

Contribution 34 

Contribution Rates 43 

Reserve Accounts 43 



Article 5. 


Article 6. 


Article 7. 


Article 8. 


Article 9. 


Chapter 5. 


Article 1. 


Article 1.5, 


Article 2. 


Article 2.4, 


Article 2.7. 


Article 3. 



Article 4. 
Article 5. 

Chapter 5.5. 
Chapter 5.6. 
Chapter 5.7. 

Chapter 6. 

Chapter 7. 

Chapter 8. 

Chapter 9. 
Article 1. 
Article 2. 

Chapter 9.5. 

Chapter 10. 



Page 

Transfer of Reserve 

Accounts 45 

Records, Reports and 

Contribution Payments 46 

Payment of Reported 

Contributions 53 

Assessments 53 

Refunds and Overpayments 54 

Unemployment Compensation 

Benefits 54 

Eligibility and 

Disqualifications 54 

Retraining Benefits 94 

Computation (Amount and 

Duration) 94 

Work Sharing Unemployment 
Insurance Benefits 94 

Irregular or Infrequent Wage 
Payments 96.3 

Filing, Determination, and 
Payment of Unemployment 
Compensation Benefit 
Claims 96.4 

Overpayments 104.2 

Rights of Trainees 106 

Unemployment Compensation for 

State Employees 106 

Unemployment Compensadon for 
County Employees 107 

Unemployment Compensation for 

State Higher Education 

Employees 107 

Financial Provisions 107 

Collections 107 

Hearing Procedure 109 

Public Employment Offices 109 

Job Services 109 

Appeals 110.1 

Employment for Older Workers 113 

Violations 113 



Page i 



(7-18-2008) 



Title Table of Contents 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



Page 

Part 2. Disability Compensation 114 Division 2 

Chapter 1. General Provisions 114 



Page 

Work Incentive Programs 132.5 



Chapter 2. Disability Benefits 116 

Article 1. Eligibility 116 

Article 2. Computation (Amount and 

Duration) 118 

Article 3. Determinations of Continuing 

Eligibility 118 

Article 4. Filing, Determination and 
Payment of Disability 
Benefit Claims 118.2 

Article 5. Overpayments 123 

Article 6. Rights of Trainees 123 

Article 7. Rights of Industrially 

Disabled Persons 124 

Chapter 3. Additional Benefits 124 

Chapter 3.5. Prorated Benefits 124 

Chapter 4. Contributions 124 

Chapter 5. Financial Provisions 124 

Article 1. Disability Fund 124 

Article 2. Disability Administration 

Account 124 

Article 3. Disability Benefit Payment 

Account 124 

Article 4. Extended Liability Account 125 

Article 5. Investments in Buildings 125 

Chapter 6. Voluntary Plans 125 

Chapter 7. Family Temporary Disability 

Insurance 131 

Part 3. Extended Unemployment 

Compensation 1 32.5 

Chapter 1. General Provisions 132.5 

Chapter 2. Extended Duration Benefits 132.5 

Article 1. Eligibility and 

Disqualifications 132.5 

Article 2. Computation (Amount and 

Duration) 132.5 

Article 3. Filing, Determination, and 
Payment of Extended 
Duration Benefit Claims 132.5 

Article 4. Reserve Accounts 132.5 

Article 5. Overpayments 132.5 

Chapter 4. Retraining Benefits 132.5 



Chapter 1. Employment Preparation 

Program 132.5 

Article 1. Job Search Assistance 132.5 

Article 2. Pilot Payment Component 132.5 

Division 2.5. Withholding Tax on Wages 132.6 

Chapter 1. General Provisions 132.6 

Chapter 2. Withholding and Payment of Tax 148 

Chapter 3. Withholding Exemptions 153 

Chapter 4. Reports, Returns, and 

Statements 1 54 

Chapter 5. Collections 155 

Division 3. Employment Services Programs 155 



Part 1. 



Employment and Employability 

Services 155 



Chapter 1. General Provisions and 

Definitions 155 

Chapter 1.5. Employment Training Panel 155 

Article 1. General Provisions 155 

Article 2. Proposal Process 158.1 

Article 4. Program Operations 158.1 1 ^|ft 

Chapter 2. Job Training Partnership Act 

Complaints 158.15 

Article 1. General Provisions 158.15 

Article 2. Service Delivery Area 

Complaint Procedures 158.16 

Article 3. Procedures for Requests for 
EDD Review or Appeals of 
Service Delivery Area 
Decisions 158.18 

Article 4. Appeals of EDD-Level 

Decisions 158.19 

Chapter 2.5. Youth Employment and 

Development 158.20 

Chapter 2.7. California Work-Site Education 

and Training Act 158.21 

Subdivision 2. California Unemployment 

Insurance Appeals Board 159 

Chapter 1. General 159 

Chapter 2. Field Operations 163 

Chapter 3. Appellate Operations 170 

Chapter 4. California Unemployment 
Insurance Appeals Board — 
Conflict of Interest Code 172.2 



Page ii 



(7-18-2008) 



Title 22 



Social Security 

Page 

California Department of Part 2. 

Aging 173 

California Department of Aging — 

Conflict of Interest Code 173 Subdivision 1. 

Title III Programs— Definitions 173 Chapter 1. 

Title III Programs — PSAs and Article 1 

AAAs 174.1 

Article 2. 
Designation of PSAs and 

AAAs 174.1 * ■ , o 

Article 3. 

AAA's General ^^^.^1^4 

Responsibilities 174.4 

Area Plans 174.5 ^, 

Chapter 2. 

AAA Procurement Procedures ... 174.9 

Grievance Process 174. 12 Chapter 3 

Sanctions 174. 1 3 

Title III Programs— Program and Chapter 4. 

Service Provider Requirements 174.15 

General Requirements for 

Programs and Service Subdivision 2. 

Providers 174.15 

Chapter 1. 
Information and Assistance 174.15 

Multipurpose Senior Centers 174.18 p. ^ 

Legal Assistance 174.20 

Title III C-Elderly . Chapter 2. 1 . 

Nutrition Program 174.20 

Title III Programs— State Subdivision 4. 

Hearings 1 74.24 

Office of the State Long-Term Chapter 1 . 

Care Ombudsman 174.27 

Long-Term Care Ombudsman Chapter 2. 

Program Provisions 174.27 

Chapter 2.5. 
Ombudsman Duties 174.27 

Violations and Enforcement 174.27 

Planning and Service Areas Chapter 3. 

(PSAs) and Area Agencies on Subchapter 1. 

Aging (AAAs) 174.28 

Title III Programs— State Subchapter 2. 

Hearings 174.28 Article 1 . 

Department of Social Services — 

Department of Health Article 2 

Services 175 

Department of Social Article 3. 

Services — Manuals of Subchapters. 

Policies and Procedures 175 



Title Table of Contents 

Page 

Health and Welfare Agency — 

Department of Health 

Services Regulations 175 

Health and Welfare Agency 175 

Displaced Homemakers 

Programs 175 

Definitions 1 75 

Priority for Services for 

Eligible Participants 176 

Stipends for Job Training 176 

Sliding Fee Schedule: 

Workshops 1 77 

Health and Welfare Agency — 

Conflict of Interest Code 177 

Safe Drinking Water and Toxic 
Enforcement Act of 1986 178 

Hazardous Substance Cleanup 

Arbitration Panel Hearing 

Regulations 201 

Administration 201 

Department of Social Services — 
Conflict of Interest Code 201 

Department of Health Services — 
Conflict of Interest Code 202 

Department of Health Services 

Audits and Appeals 202 

Institutions and Boarding Homes 

for Persons Aged 16 and Above 206 

General Provisions and 

Definitions 206 

Licensing Agencies 206 

Maternity Home Care Program: 

Pregnancy Freedom of Choice 

Act 206 

Adoptions Program Regulations 210 

Adoptions Program 

Terminology 210 

General Requirements 213 

Correction, Alteration, 

Translation and Reading of 

Forms 213 

Recruitment — Agency 

Adoptions 217 

Staffing Requirements 219 

Administrative 

Requirements 220 



Division 1.8. 

Chapter 1 . 

Chapter 2. 
Chapter 3. 

Article 1 . 

Article 2. 

Article 3. 
Article 4. 
Article 5. 
Article 6. 

Chapter 4. 
Article 1. 

Article 2. 
Article 3. 
Article 4. 
Article 5. 

Chapter 5. 

Chapter 6. 

Article 1. 

Article 2. 
Article 3. 

Chapter 4. 

Article 7. 
Division 2. 

Part 1. 



Page iii 



(7-18-2008) 



Title Table of Contents BARCLAYS CALIFORNIA 

Page 

Article 1. Administration of Public and 

Private Agencies 220 

Article 1.1. Unavailability of Verifying 

Documents 221 

Article 2. Content of Case Record 221 

Article 3. Procedures for Post-Adoption 

Services 222 

Article 4. Private Adoption Agency 

Reimbursement Program 225 

Subchapter 4. Procedures for 

Independent Adoptions 226 

Article 1. Agency Responsibility 226 

Article 2. Placement for Independent 

Adoption 229 

Article 3. Prerequisites to Consent 232 

Article 3.1. Freeing a Child for 

Adoption 238 

Article 4. Accepting Consent 239 

Article 5. Finalization of Adoption 240 

Article 6. Procedures in Denials and 

Commitments 241 

Subchapter 5. Procedures for Agency 

Adoptions 242 

Article 1. Assessment of the Child 242 

Article 2. Freeing a Child for 

Adoption 243 

Article 3. Services for the Birth 

Parents 244 

Article 4. Prerequisites to Accepting a 

Relinquishment 248 

Article 5. Accepting the 

Rehnquishment 249 

Article 6. Accepting the Statement of 

Understanding 252 

Article 7. Revocation of 

Relinquishment 260.2 

Article 8. Filing of Relinquishment 260.4 

Article 9. Rescission of 

Relinquishment 260.4 

Article 10. Application to Adopt 260.6 

Article 11. Assessment of the Apphcant 260.8 

Article 12. Adoptive Placement 260.12 

Article 13. Completing the Adoption 260.16 

Article 14. Grievance Review 260.18 

Subchapter 6. Procedures for 

Intercountry Adoptions 260.20 



CODE OF REGULATIONS Title 22 

Page 

Article 1. General and Administrative 

Requirements 260.20 

Article 2. Application for the 

Placement of a Child for 

Adoption 260.21 

Article 3. Assessment of the Applicant 260.21 

Article 4. Assessment of the Child 260.24 

Article 5. Background Information on 

the Birth Parents 260.25 

Article 6. Placement 260.25 

Article 7. Supervision of Adoptive 

Placement 260.26 

Article 8. Intercountry Adoption Court 

Report 260.27 

Subchapter 7. Adoption Assistance 
Program/Aid for the 
Adoption of Children 
(AAP/AAC) 260.28 

Article 1. AAP Case Initiation 260.28 

Article 2. AAP Eligibility 

Requirements 260.29 

Article 3. AAP Payments 260.30 

Article 4. Adoption Assistance Program 

Agreement 260.32 

Article 5. AAP Payment Authorization 260.33 

Article 6. AAP Reassessment 260.33 

Article 7. AAP Overpayments 260.34 

Article 8. Notice of Action 260.35 

Article 9. Continuation of Aid for the 

Adoption of Children (AAC) .... 260.35 

Article 10. Documentation of AAP 

Eligibility 260.35 

Article 11. Reimbursement for 

Nonrecurring Adoption 

Expenses 260.36 

Subchapter 8. Adoption of Children with 

Indian Heritage 260.36(a) 

Article 1 . Additional Agency 

Requirements for Adoption 

of Children with Indian 

Heritage 260.36(a) 

Article 2. Certification of Degree of 

Indian Blood (CDIB), Tribal 
Membership Eligibility, and/ 
or Tribal Enrollment 260.36(a) 

Article 3. Background Information 260.37 

Article 4. Information to Parents of a 
Child with Indian Heritage 
Regarding Provisions of the 
ICWA 260.37 



Page iv 



(7-18-2008) 



Title 22 



Social Security 

Page 

Freeing the Indian Child for Article ] . 

Adoption 260.38 Article 2. 

Information Transmitted to Article 3 

Applicants in Agency 

Adoptions 260.39 

Article 4. 
Placement and Supervision in 
an Agency Adoption 260.39 Article 5. 

Information Transmitted to 

r, ,v Article 6. 

Petitioners in an 

Independent Adoption 260.39 

Information Transmitted to 

the Adoptee 260.40 Article 8. 

Interstate Compact on the Chapter 5. 

Placement of Children 

(ICPC) 260.40 A • , 1 

^ ' Article 1. 

Definitions and Conditions 260.40 * • i ^ 

Article 2. 

Rehnquishment Adoptions 260.40 a i" 1 '^ 

Independent Adoptions 260.41 

Minimum Standards for Facilities Chapter 6. 

for Children 260.43 

Day Nurseries 260.43 

Minimum Standards for 

Residential Care Homes for Article 2. 

Adults 260.43 

^ . . r. A Article 3. 

Continuing Care Agreements 260.43 

Article 4. 
Preventive Medical Services 260.43 

California Health Services 

Corps 260.43 Article 6. 

Definitions 260.43 Article 7. 

Eligibility 260.44 Article 8. 

Apphcation 261 Article 9. 

Personnel 261 

Charges and Reimbursements 262 a _^- i m 

° Article 10. 

Recipient Rights 263 Article 11. 

Rural Health Services Article 12. 

Development Projects 263 

Chapter 8. 
Definitions 263 

Applicants 264 

Types of Assistance 264 Article 1 . 

Application for Financial Article 2. 

Assistance 264 Article 3. 

Charges and Reimbursements 265 Article 4 

Recipient Rights 265 Article 5. 

Victims of Sexual Assault 266 Chanter 9 

Sickle Cell Screening Program 266 Article 1 . 



Title Table of Contents 

Page 

Definitions 266 

Scope of the Regulations 266 

Approval of a Sickle Cell 

Screening Program 266 

Services 266 

Sickle Cell Screening 

Laboratory Services 266 

Certification of Sickle Cell 
Counselors 266 

Participant Rights 267 

Community Relationship 267 

Assistance to Primary Care 

Chnics 267 

Definitions 267 

Eligibility for Grant 268 

Administration of the Grants 

Program 269 

California Special Supplemental 

Food Program for Women, Infants 

and Children 269 

Definitions 269 

Certification of 

Participants 272 

Nondiscrimination 275 

Fair Hearing Procedures for 
Participants 276 

Supplemental Foods 276 

Nutrition Education 276.1 

Food Delivery System 276.1 

Selection of Local Agencies 288.3 

Administrative Appeal of 

Departmental Decisions 

Affecting Local Agencies 289 

Investigations 290 

Penalties 290 

Records and Reports 290 

Human Immunodeficiency Virus 
(HIV) Testing of Inmates in 
Correctional Facilities 291 

Definitions 291 

Procedures 292 

Appeals Process 295 

Testing Procedures 298.1 

Counseling 298.2 

Tuberculosis Examination 298.3 

Application 298.3 



Article 5. 


Article 6. 


Article 7. 


Article 8. 


Article 9. 


Subchapter 9 


Article 1. 


Article 2. 


Article 3. 



Chapter 4. 



Subchapter 2, 


Chapter 5. 


Chapter 6. 


Subdivision 6. 


Chapter 1. 


Article 1. 


Article 2. 


Article 3. 


Article 4. 


Article 5. 


Article 6. 



Chapter 2. 

Article 1. 
Article 2. 
Article 3. 
Article 4. 

Article 5. 
Article 6. 

Chapter 3. 

Chapter 4. 



Page V 



(7-18-2008) 



Title Table of Contents BARCLAYS CALIFORNIA 

Page 

Article 2. Definitions 298.3 

Article 3. Tuberculosis Examination 298.3 

Article 4. Admission to School 298.3 

Article 5. Records 298.4 

Article 6. Reporting 299 

Article 7. Exclusion from School 299 

Subdivision 7. California Children's Services 299 

Chapter 1. Definitions 299 

Chapter 2. Administration 302 

Article 1. General Provisions 302 

Article 5. Records and Reports 302.1 

Chapter 3. Application Process 302.1 

Article 1. General Provisions 302.1 

Chapter 4. Medical Eligibility 302.2 

Article 1. General Provisions 302.2 

Chapter 5. Residential Eligibility 302.7 

Article 1. General Provisions 302.7 

Chapter 6. Financial Eligibility 302.8 

Article 2. Other Provisions 302.8 

Article 3. CCS Legal Agreement 302.8 

Article 4. Annual Enrollment Fee 302.9 

Article 5. Annual EnrollmentFee 

Collection 302.9 

Chapter 7. Program Benefits 302.9 

Article 3. Diagnostic Services 302.9 

Article 4. Treatment Services 302.10 

Article 6. Authorization for Services 302.10 

Chapter 9. Professional Medical Care 

Providers 302.10 

Article 1. General Provisions 302.10 

Article 3. Physicians 302.10 

Article 4. Other Health Care 

Professionals 302. ii 

Chapter 10. Hospital Providers 302.1 1 

Article L General Provisions 302.11 

Article 4. Special Hospital 303 

Chapter 13. Resolution of Complaints and 
Appeals by CCS Clients or 
Applicants 303 

Article 1. Notice of Action 303 

Article 2. Designated CCS Agency 304 

Article 3. CCS Fair Hearing 304 



CODE OF REGULATIONS Title 22 

Page 

Chapter 14. Other CCS Programs 304.3 

Article 1. Immunization Adverse 

Reaction Fund 304.3 

Division 2.1 . Department of Rehabilitation 305 

Chapter 1 . Programs for the Blind 305 

Chapter 2. Vocational Rehabilitation 

Programs 303 

Division 3. Health Care Services 307 

Subdivision 1. California Medical Assistance 

Program 307 

Chapter 1. Introduction 307 

Chapter 2. Determination of Medi-Cal 

Eligibility and Share of Cost 308 

Article 1. Definitions, Abbreviations 

and Program Terms 308 

Article 2. Administration 317 

Article 3. County of Responsibility for 
Determination of Medi-Cal 
Eligibility 320 

Article 4. Beneficiary Application 

Process 322 

Article 5. Medi-Cal Programs 336.7 

Article 6. Institutional Status 341 

Article 7. Ahenage, Citizenship and 

Residence 342 

Article 8. Responsible Relatives and 

Unit Determination 348 

Article 9. Property 350.3 

Article 10. Income 362.2 

Article 11. Maintenance Need 374 

Article 12. Share of Cost 375 

Article 13. Period of Eligibility 378 

Article 14. Medi-Cal Card Use and 

Issuance 379 

Article 15. Other Health Care Coverage 
and Medicare Buy-In 
Coverage 382 

Article 16. Overpayments, Fraud and 

Improper Utilization 386 

Article 17. Dialysis Medi-Cal Program 386.3 

Article 18. State Administrative 

Hearings 389 

Article 19. Medi-Cal Estate Recovery 390 

Chapter 2.5. Third Party Liability 390 

Article 1. Definitions 390 



Page vi 



(7-18-2008) 



Title 22 



Social Security 
Page 

Estate Recovery 392 Article 4. 

Health Care Services 392.4 

Application and Enrollment 392.4 

General Provisions 394. 11 Air 

Article 5. 

Provider Audit Appeals 396.3 

Skilled Nursing Facility and Article 6. 

Intermediate Care Facility Article 7. 

Certification Appeals 
Procedure 402 

Definitions 403 Chapter 4.5. 

Standards for Participation 424 

Scope and Duration of 

Benefits 436.3 Article 2. 

Scope and Duration of Article 3. 

Supplemental Schedule of 

Benefits 466.1 

Ehgibility for Payment 466.1 Chapter 5. 

Payment for Services and 

Supphes 471 Article 2. 

Hospital Inpatient Services Article 3. 

Reimbursement Section 516.4(d)(7) 

Article 4 
Conflict of Interest 516.19 

Article 5. 

Early and Periodic . , ^ 

e . r^- A Article 6. 

Screening, Diagnosis, and 

Treatment Program 517 Chapter 5.5. 

Pilot and Demonstration 

Projects 517 

Chapter 6. 

Prepaid Health Plans 517 

General Provisions 517 Article 1 . 

^ ^. . . Article 2. 

Definitions 517 

Article 3. 

Operational Requirements 520 

^ Article 4. 

Marketing, Enrollment and 

Disenrollment 528 Articles. 

Applications, Contracts and Article 6. 

Pubhc Hearings 530 

Chapter 7. 
Conflict of Interest 532 

Emergency Services Claims Article 1. 

D^^P"^^^ "2 ^^.^j^2. 

Two-Plan Model Managed Care 

Program 538 

Article 3. 
General Provisions 538 

Definitions 538 ^. , <, 

Chapter 8. 

Maximum Enrollment Levels 538.2 



Title Table of Contents 

Page 

Prepaid Health Plan and 

Primary Care Case 

Management Plan Enrollment 

Growth During the 

Transition Period 538.2 

Two-Plan Model 

Requirements 538.2(a) 

Operational Requirements 538.2(c) 

Marketing, Enrollment, 

Assignment, and 

Disenrollment 538.2(1) 

Geographic Managed Care 

Program 538.2(r) 

General Provisions 538.2(r) 

Operational Requirements 538.3 

Marketing, Enrollment, 

Assignment, and 

Disenrollment 538.6 

Adult Day Health Care 538.10 

General Provisions 538.10 

Definitions 538.10 

Eligibility, Participation 

and Discharge 539 

Services and Standards 541 

Administration 546 

Payment of Services 551 

Indians and Indian Health 
Service Facilities in Medi-Cal 
Managed Care Programs 552 

Primary Care Case Management 

Plans 552.3 

General Provisions 552.3 

Definitions 552.4 

Operational Requirements 556 

Marketing, Enrollment and 
Disenrollment 565 

Application and Proposal 568.1 

Conflict of Interest 568.3 

Construction/Renovation 
Reimbursement Program 568.4 

Definitions 568.4 

Eligibility for Construction/ 
Renovation Reimbursement 
Program 570 

Standards for Supplemental 
Reimbursement 570 

California Partnership for Long- 
Term Care 571 



Article 2. 

Chapter 3. 
Article L 
Article 1.3. 
Article 1.5. 
Article 1.6. 



Article 2. 
Article 3. 
Article 4. 

Article 5. 



Article 6. 


Article 7. 


Article 7.5 


Article 8. 


Article 10. 



Chapter 3.5. 

Chapter 4. 
Article 1. 
Article 2. 
Article 3. 
Article 4. 

Article 5. 

Article 6. 
Article 7. 

Chapter 4.1. 

Article 1. 
T^rticle 2. 
Article 3. 



Page vii 



(7-18-2008) 



Title Table of Contents BARCLAYS CALIFORNIA 

Page 

Article 1. Definitions 371 

Article 2. Conditions of Issuer 

Participation 578 

Article 3. Benefits and Provisions for 
Partnership Policies and 
Certificates 584 

Article 4. Premium Provisions 589 

Article 5. Care Management Provider 

Agency Standards 590 

Article 6. Issuer Reporting 

Requirements and Audit 

Information 592 

Chapter 1 1 . Drug Formulary and Medical 

Supplies Listing 596 

Article 1 . Medical Supplies and Medi- 

Cal Drug Formulary 596 

Division 4. Environmental Health 599 

Chapter 1. Introduction 599 

Article 1. Definitions 599 

Chapter 2. Regulations for the 

Implementation of the 

California Environmental 

Quality Act 599 

Article 1 . General Requirements and 

Categorical Exemptions 599 

Chapter 3. Water Recycling Criteria 600 

Article 1 . Definitions 600 

Article 2. Sources of Recycled Water 602.1 

Article 3. Uses of Recycled Water 602.1 

Article 4. Use Area Requirements 602.2 

Article 5. Dual Plumbed Recycled Water 

Systems 602.4 

Article 5.1. Groundwater Recharge 602.4 

Article 5.5. Other Methods of Treatment ..... 602.5 

Article 6. Sampling and Analysis 602.5 

Article 7. Engineering Report and 

Operational Requirements 602.5 

Article 8. General Requirements of 

Design 603 

Article 9. Alternative Reliability 
Requirements for Uses 
Permitting Primary 
Effluent 603 



CODE OF REGULATIONS Title 22 

Page 

Article 10. Alternative Reliability 
Requirements for Uses 
Requiring Oxidized, 
Disinfected Wastewater or 
Oxidized, Coagulated, 
Clarified, Filtered, 
Disinfected Wastewater 603 

Article 1 1 . Other Methods of Treatment 604 

Chapter 4. Water Treatment Devices 604 

Article 1. Definitions 604 

Article 2. Certification Requirements 605 

Article 3. Apphcation Requirements 605 

Article 4. Testing and Testing 

Protocols 606 

Article 5. Product Labeling and Data 

Sheet Requirements 609 

Article 6. Fees 609 

Chapter 12. Safe Drinking Water Project 

Funding 609 

Article 1 . Definitions 609 

Article 2. Financing Criteria 610.2 

Article 3. Disadvantaged Communities 610.4 

Article 4. Application Process 610.4 

Article 5. Information to Be Submitted 
Prior to Execution of the 
Funding Agreement 610.6 

Article 6. Design and Construction 610.6 

Article 7. Claims and Loan Repayments 610.6 

Article 8. ConsoHdation Projects 610.6(a) 

Chapter 13. Operator Certification 610.6(a) 

Article 1. Definitions 610.6(a) 

Article 2. Operator Certification 

Grades 610.7 

Article 3. Operator Examination 

Criteria and Applications 610.8 

Article 4. Operator Certification 

Criteria and Applications 610.9 

Article 5. Certification Renewals, 
Dehnquent Renewals and 
Fees 610.12 

Chapter 14. Water Permits 610.13 

Article 1. Apphcations 610.13 

Article 3. State Small Water Systems 610.14 

Article 4. Local Primacy Delegation 61 1 

Chapter 15. Domestic Water Quality and 

Monitoring Regulations 615 

Article 1. Definitions 615 



Page viii 



(7-18-2008) 



Title 22 



Social Security 
Page 

General Requirements 616.4 Article 4. 

Primary Standards — 

Bacteriological Quality 616.7 

Primary Standards — Inorganic 

Chemicals 616.10 Article 6. 

Tribal omethanes 616.10(c) Article 7. 

Radioactivity 616.10(c) Article 8. 

Primary Standards — Organic 

Chemicals 616.12 Chapter 17. 

Best Available Technologies Article 1. 

(BAT) 616.15 

Treatment Techniques 616.17 Article 2. 

Secondary Drinking Water 

Standards 616.18 

Special Monitoring . . . ^ 

n . , r Articles. 

Requirements tor 

Unregulated Chemicals 616.20 Article 4. 

Notification of Water Article 5 . 

Consumers and the Article 6. 

Department 616.21 * • , ^ 

^ Article 7. 

Records, Reporting and 

Recordkeeping 616.29 ^^.^j^ g 

Consumer Confidence Report . . . 616.30 

Chapter 17.5. 

Disinfectant Residuals, Article 1 

Disinfection Byproducts, and 

Disinfection Byproduct 

Precursors 616.34 /^mcie z. 

General Requirements and 

Definitions 616.34 ^^^^^^ ^■ 

Maximum Contaminant Levels a • i /t 

for Disinfection Byproducts 

and Maximum Residual 

Disinfectant Levels 616.34 Article 5. 

Monitoring Requirements 616.39 Article 6. 

Compliance Requirements 616.41 

Treatment Technique for Article 7 

Control of Disinfection 
Byproduct Precursors 

(DBPP) 616.42 

Article 8. 
Reporting and Recordkeeping 

Requirements 616.44 

California Wateru/orks Article 9. 

Standards 616.45 

Definitions 616.45 Chapter 18. 

Waivers and Alternatives 616.46 Article 1. 

Permit Requirements 616.46 Ch t 1 Q 

Water Sources 619 



Title Table of Contents 

Page 

Materials and Installation 

of Water Mains and 

Appurtenances 620 

Disinfection Requirements 621 

Distribution Reservoirs 622 

Additives 622 

Distribution System 

Operation 622. i 

Surface Water Treatment 622.3 

General Requirements and 

Definitions 622.3 

Treatment Requirements, 
Watershed Protection 
Requirements, and 
Performance Standards 622.5 

Monitoring Requirements 622.6(b) 

Design Standards 622.6(b)(3) 

Operation 622.6(b)(3) 

Reporting 622.6(b)(4) 

Watershed Sanitary 

Surveys 622.6(b)(5) 

Public Notification 622.6(b)(5) 

Lead and Copper 622.6(b)(6) 

General Requirements and 

Definitions 622.6(b)(6) 

Requirements According to 

System Size 622.6(e) 

Monitoring for Lead and 

Copper 622.6(1) 

Water Quality Parameter 

(WQP) Monitoring 622.6(i) 

Corrosion Control 622.60) 

Source Water Requirements 

for Action Level 

Exceedances 622.6(k) 

Public Education Program for 

Lead Action Level 

Exceedances 622.6(1) 

Lead Service Line 

Requirements for Action 

Level Exceedances 622,6(o) 

Reporting and 

Recordkeeping 622.6(p) 

Drinking Water Additives 622.6(q) 

Requirements 622.6(q) 

Certification of Environmental 
Laboratories 622.6(q) 



Article 2. 


Article 3. 


Article 4. 


Article 4.5 


Article 5. 


Article 5.5, 


Article 12. 


Article 14. 


Article 16. 


Article 17. 


Article 18. 


Article 19. 


Article 20. 


Chapter 15.5. 



Article 1. 
Article 2. 



Article 3. 
Article 4. 
Article 5. 



Article 6. 

Chapter 1 6. 

Article 1. 
Article 1.5. 
Article 2. 
Article 3. 



Page ix 



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Title Table of Contents BARCLAYS CALIFORNIA 

Page 

Article 1. Definitions 622.6(q) 

Article 2. Certification and Amendment 

Process 622.7 

Article 3. Application Process 622.8 

Article 4. Site Visits 622.8 

Article 5. Performance Evaluation 

Testing Process 622.9 

Article 6. Required Test Methods 622.9 

Article 7. Laboratory and Equipment 622.10 

Article 8. Quality Assurance 

Documents 622.10 

Article 9. Laboratory Personnel 622.10 

Article 10. Notification and Reporting 622.11 

Article 1 1 . Reciprocity Agreements 622.12 

Article 12. Subgroups for Fields of 

Testing 622.12 

Article 13. Trade Secrets 622.14 

Article 14. Sale or Transfer of 

Ownership of a Laboratory 622.14 

Article 16. National Environmental 
Laboratory Accreditation 
Program (NELAP) 622.15 

Chapter 20. Public Swimming Pools 622.15 

Article 1 . Definitions and Scope 622.15 

Article 2. Plans, Construction and 

Inspection 623 

Article 3. Maintenance and Operation 623 

Chapter 21. Minimum Standards for Permitting 

Medical Waste Facilities 625 

Article 1. Definitions and Scope 625 

Article 2. General Provisions 626 

Article 3. Medical Waste Treatment 

Facility Permits 626.1 

Article 4. Fees 626.4 

Chapter 22. Safety Regulations for 

Playgrounds 626.4 

Article 1. Definitions 626.4 

Article 2. General Standards 626.5 

Article 3. Certified Playground Safety 

Inspector Requirements 626.6 

Article 4. Provisions for Child Care 
Centers and Facilities 
Operated for the 
Developmentally Disabled 626.6 



CODE OF REGULATIONS Title 22 

Page 

Division 4.5. Environmental Health Standards 
for the Management of 
Hazardous Waste 627 

Chapter 10. Hazardous Waste Management 

System: General 627 

Article 1 . General 627 

Article 1.5. Conflict of Interest Code 635 

Article 2. Definitions 637 

Article 3. Variances 657 

Chapter 11. Identification and Listing of 

Hazardous Waste 660 

Article 1 . General 660 

Ai'ticle 2. Criteria for Identifying the 
Characteristics of 
Hazardous Waste 668.3 

Article 3. Characteristics of Hazardous 

Waste 668.3 

Article 4. Lists of Rcra Hazardous 

Wastes 668.6 

Article 4. 1 . Additional Lists of 

Hazardous Wastes 681 

Article 5. Categories of Hazardous 

Waste 681 

Chapter 12. Standards Applicable to 

Generators of Hazardous Waste 692 

Article 1 . Applicability 692 

Article 2. The Manifest 693 

Article 3. Pre-Transport Requirements 694 

Article 4. Recordkeeping and Reporting 698 

Article 5. Exports of Hazardous Waste 699 

Article 6. Imports of Hazardous Waste 702 

Article 7. Farmers 703 

Article 8. Transfrontier Shipments of 
Hazardous Waste for 
Recovery Within the OECD 703 

Chapter 13. Standards Applicable to 

Transporters of Hazardous 

Waste 714 

Article 1. General 714 

Article 2. Compliance with the Manifest 

System and Recordkeeping 715 

Article 3. Hazardous Waste Discharges 718 

Article 4. Regulatory Exemptions for 
Certain Transportation 
Operations 718 

Article 5. Railroad Accident Prevention 
and Immediate Deployment 
(RAPID) Force 720.1 



Page X 



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Title 22 



Social Security 

Page 

Standards for Owners and Chapter 15. 

Operators of Hazardous Waste 

Transfer, Treatment, Storage, 

and Disposal Facilities 720.] 

General 720.1 

Article 1. 
General Facility Standards 720.3 

Article 2. 
Preparedness and Prevention 720.7 a t' l '^ 

Contingency Plan and 

Emergency Procedures 720.7 Article 4 

Manifest System, 

Recordkeeping, and Article 5. 

Reporting 720.9 

Water Quality Monitoring and 

Response Programs for Article 6. 

Permitted Facilities 720.14 

Closure and Post-Closure 728 

Article 7. 

Financial Requirements 734 . . , „ 

Article 8. 

Use and Management of Article 9 

Containers 750.18 

Tank Systems 752 Article 10. 

Surface Impoundments 755 Article 11. 

Waste Piles 758.3 Article 12. 

Land Treatment 758.6 ^^^^^^ ^^■ 

T jr-n Article 14. 

Landfills 758.10 

Article 15. 

Residuals Repositories 758.12(c) . . , , ^ 

Article 16. 

Incinerators 758.12(d) Article 17. 

Corrective Action for Waste 

Management Units 758.14 Article 17.5. 

Drip Pads 758.16(d) Article 18. 

Miscellaneous Units 758.18 

Environmental Monitoring and Article 27 

Response Programs for Air, 

Soil, and Soil-Pore Gas for 

Permitted Facilities 758.18(a) Article 28. 

Corrective Action for Solid * _.■ i '^o c 

Article 28.5. 
Waste Management Units 758.18(d) 

Air Emission Standards for 

Process Vents 758.45 

Air Emission Standards for Article 29. 

Equipment Leaks 758.52 ^^^^^^^ ^^ 

Air Emission Standards for 

Tanks, Surface Article 1. 

Impoundments, and a • i o 

Containers 758.54(d) 

Containment Buildings 758.54(s) 



Title Table of Contents 

Page 

Interim Status Standards for 

Owners and Operators of 

Hazardous Waste Transfer, 

Treatment, Storage, and 

Disposal Facilities 758.54(u) 

General 758.54(u) 

General Facility Standards 758.54(w) 

Preparedness and 

Prevention 758.54(z)(l) 

Contingency Plan and 

Emergency Procedures 758.54(z)(l) 

Manifest System, 

Recordkeeping, and 

Reporting 758.54(z)(3) 

Water Quality Monitoring and 

Response Programs for 

Interim Status Facilities 758.54(z)(8) 

Closure and Post-Closure 758.62 

Financial Requirements 758.69 

Use and Management of 

Containers 758.81 

Tank Systems 758.81 

Surface Impoundments 758.90 

Waste Piles 758.93 

Land Treatment 758.95 

Landfills 758.98 

Incinerators 758.103 

Thermal Treatment 758.104 

Chemical, Physical, and 

Biological Treatment 758.105 

Drip Pads 758.106 

Environmental Monitoring of 

Air and Soil-Pore Gas for 

Interim Status Facilities 758.108 

Air Emission Standards for 

Process Vents 758.112(a) 

Air Emissions Standards for 
Equipment Leaks 758.112(g) 

Air Emission Standards for 

Tanks, Surface 

Impoundments, and 

Containers 758.il2(l)(l) 

Containment Buildings .... 758.1 12(I)(23) 

Recyclable Materials (Recyclable 
Hazardous Wastes) 758.1 I2(n) 

General 758.1 12(n) 

Generator, Transporter and 

Facility Operator 

Requirements 758.1 ]2(n) 



Chapter 14. 

Article 1. 
Article 2. 
Article 3. 
Article 4. 

Article 5. 
Article 6. 



Article 7. 


Article 8. 


Article 9. 


Article 10. 


Article 11. 


Article 12. 


Article 13. 


Article 14. 


Article 14.5 


Article 15. 


Article 15.5 


Article 15.7 


Article 16. 


Article 17. 



Article 19. 
Article 27. 
Article 28. 
Article 28.5. 

Article 29. 



Page xi 



(7-18-2008) 



Title Table of Contents BARCLAYS CALIFORNIA 

Page 

Article 3. Requirements for Recyclable 

Materials That Are Placed 
on the Land (Used in a 
Manner That Constitutes 

Disposal) 758.112(0) 

Article 4. Hazardous Wastes and Certain 
Used Oils Regulated as 
Hazardous Waste Fuels 758.l]2(p) 

Article 5. [Reserved] 758.1 I2(q) 

Article 6. Requirements for Management 

of Used Oil 758.1 12(q) 

Article 7. Requirements for Management 
of Spent Lead-Acid Storage 
Batteries 758.1 ]2(r) 

Article 8. Hazardous Waste Burned in 
Boilers and Industrial 
Furnaces 758.ll2(s) 

Article 8.5. Requirements for 

Management of Recyclable 

Materials Used in 

Agriculture 758.ll2(z)(l4) 

Article 9. Requirements for 

Management of Waste 

Elemental Mercury 758.1 12(z)( 15) 

Article 10. Requirements for 

Management of Certain 

Oily Wastes 758.ii2(z)(l5) 

Chapter 17. Military Munitions 758.l22(z)(2) 

Chapter 18. Land Disposal 

Restrictions 758.l22(z)(2) 

Article 1. General 758.122(z)(2) 

Article 2. Schedule for Land Disposal 
Prohibition and 
Establishment of Treatment 
Standards 758.123 

Article 3. Prohibitions on Land 

Disposal 758.128 

Article 4. Treatment Standards 758.133 

Article 5. Prohibitions on Storage 758.190 

Article 10. Land Disposal Prohibitions — 

Non-RCRA Wastes 758.191 

Article 1 1 . Treatment Standards — Non- 
RCRA Waste Categories 758.191 

Article 12. Incineration Requirements of 

Certain Hazardous Waste 758.192(b) 

Chapter 19. Fees 758.262 

Chapter 20. The Hazardous Waste Permit 

Program 758.271 

Article 1. General Information 758.271 



CODE OF REGULATIONS Title 22 

Page 

Article 2. Permit Application 758.273 

Article 3. Permit Conditions 758.287 

Article 4. Permit Changes and Denials 758.289 

Article 5. Expiration and Continuation 

of Permits 758.294 

Article 6. Special Forms of Permits 758.294 

Article 6.5. Standardized Permits 758.300(b) 

Article 7. Interim Status 758.300((l) 

Chapter 21. Procedures for Hazardous Waste 

Permit Decisions 758.304(b) 

Article 1 . General Program 

Requirements 758.304(b) 

Article 2. Specific Procedures 
Applicable to RCRA 
Permits 758.304(h) 

Chapter 22. Enforcement, Inspections, and 

Informant Rewards 758.304(i) 

Article 1 . Inspection Authority, 

Designation of Enforcement 
Authority, and Awards 758.304(1) 

Article 2. Delegation of Enforcement 

Order Authority 758.305 

Article 3. Assessment of Administrative 

Penalties 758.306 

Chapter 23. Standards for Universal Waste 

Management 758.306(d) 

Article 1. General 758.306(d) 

Article 2. Standards for Small Quantity 
Handlers of Universal 
Waste 758.306(I)(l) 

Article 3. Standards for Large Quantity 
Handlers of Universal 
Waste 758.306(0(1 1) 

Article 4. Standards for Universal 

Waste Transporters 758.306(l)(22) 

Article 5. Standards for Destination 

Facilities 758.306(0(25) 

Article 6. Import Requirements 758.306(1)(26) 

Article 7. Standards for CRT Material 

Handlers 758.306(0(26) 

Chapter 29. Standards for the Management 

of Used Oil 758.306(1)(32) 

Article 1. Definitions 758.306(0(32) 

Article 2. Applicability 758.306(i)(33) 

Article 3. Standards for Used Oil 

Generators 758.306(m) 

Article 4. Standards for Used Oil 

Collection Centers 758.306(n) 



Page xii 



(7-18-2008) 



Title 22 



Social Security 

Page 

Standards for Used Oil Article 5. 

Transporters and Transfer 

Facilities (66279.40) 

[Reserved] 758.306(n) 

Standards for Used Oil 

Recycling Facilities 

(66279.50) [Reserved] 758.306(n) 

[Reserved] 758.306(n) Chapter 45.5. 

[Reserved] 758.306(n) 

[Reserved] 758.306(n) Article 1. 

Testing Standards and 

Recordkeeping 

Requirements 758.306(n) 

Chapter 46. 
Waste Minimization 758.3] 5 

Hazardous Waste Source 

Reduction and Management 

Review 758.313 Chapter 47. 

Article 1. 
Management of Tanks 758.325 

Best Management Practices for 
Perchlorate Materials 758.329 

General 758.329 Article 2. 

Alternative Management 

Standards for Treated Wood Chapter 50. 

Waste 758.330(c) Article 1. 

Hazardous Waste Property and 

Border Zone Property 758.330(g) Article 1.5. 

Selection and Ranking Criteria a f- i o 

for Hazardous Waste Sites 

Requiring Remedial Action 758.330(h) 

Chapter 51. 
Prohibited Chemical Toilet 

Additives 758.333 Article 1. 

Requirements for Management of 

Fluorescent Light Ballasts Chapter 5 1 .5. 

which Contain Polychlorinated Article 1 . 

Biphenyls (PCBs) 758.335 

Additional Requirements for 

Management of Extremely 

Hazardous Wastes 758.336 Chapter 52. 

Hazardous Waste Testing 

Laboratory Certification 758.336 DIvDsion 5 

Requirements for Units and 
Facilities Deemed to Have a 
Permit by Rule 758.336 

Permit By Rule 758.336 Chapter L 

[Reserved] 758.338(i) Article 1. 

[Reserved] 758.338(1) Article 2. 

[Reserved] 758.338(i) Article 3. 



Title Table of Contents 

Page 

Requirements Applicable to 

the Operation of K-12 

Schools Hazardous Waste 

Collection, Consolidation, 

and Accumulation Facilities 

(SHWCCAF) Deemed to Have 

a Permit by Rule 758.338(i) 

Procurement of Site or Facihty 

Cleanup Services 758.342 

Selection Process for 

Private Architectural and 

Engineering Services for 

Sites or Facilities 758.342 

Hazardous Waste Environmental 

Technology Certification 

Program 758.345 

Loan Programs 758.346(a) 

Cleanup Loans and 

Environmental Assistance to 

Neighborhoods Revolving 

Loan Fund 758.346(a) 

Groundwater Remediation 

Loan Program 758.346(h)(2) 

Corrective Action 758.346(j) 

Department of Toxic 

Substances Control 758.346(j) 

Unified Program Agency 
Qualification 758.347 

Corrective Action 

Approach 758.348(e) 

Site Remediation 758.348(e) 

Private Site Management 

Performance Standards 758.348(e) 

Assessment of School Sites 758.355 

Phase I Environmental Site 

Assessments (Proposed New 

and Expanding School 

Sites) 758.355 

Voluntary Registration of 
Environmental Assessors 758.358(a) 

Licensing and Certification of 
Health Facilities, Home Health 
Agencies, Clinics, and Referral 
Agencies 759 

General Acute Care Hospitals 759 

Definitions 759 

License 763 

Basic Services 767 



Article 5. 

Article 6. 

Article 7. 
Article 8. 
Article 9. 
Article 10. 



Chapter 31. 
Article 1 . 



Chapter 32. 
Chapter 33. 

Article 1. 
Chapter 34. 

Chapter 39. 
Chapter 40. 

Chapter 41. 
Chapter 42. 

Chapter 43. 

Chapter 44. 
Chapter 45. 

Article 1. 
Article 2. 
Article 3. 
Article 4. 



Page xiii 



(7-18-2008) 



Title Table of Contents BARCLAYS CALIFORNIA 

Page 

Article 4. Supplemental Service 

Approval 774 

Article 5. Special Permit 775 

Article 6. Supplemental Services 776 

Article 7. Administration 798 

Article 8. Physical Plant 808 

Article 9. Regulations Specific to 

Small and Rural Hospitals 814 

Chapter 2. Acute Psychiatric Hospital 815 

Article 1. Definitions 815 

Article 2. License 817 

Article 3. Basic Services 821 

Article 4. Supplemental Service 

Approval 826 

Article 5. Supplemental Services 827 

Article 6. Administration 827 

Article 7. Physical Plant 833 

Chapter 2.5. Certified Nurse Assistant 

Program 837 

Article 1. Definitions 837 

Article 2. Administration 840 

Article 3. Program Components 841 

Article 4. Continuing Education and In- 
Service Training 845 

Article 5. Adverse Actions and 

Corrective Remedies 847 

Chapter 3. Skilled Nursing Facilities 848 

Article 1 . Definitions 848 

Article 2. License 848.4 

Article 3. Required Services 848.5 

Article 4. Optional Services 853 

Article 5. Administration 859 

Article 6. Physical Plant 867 

Article 7. Violations and Civil 

Penalties 871 

Chapter 3.5. Receivership Management of Long- 
Term Care Facilities 873 

Chapter 4. Intermediate Care Facilities 873 

Article 1. Definitions 873 

Article 2. License 876.1 

Article 3. Services 881 

Article 4. Administration 901 

Article 5. Physical Plant 906 



CODE OF REGULATIONS Title 22 

Page 

Article 6. Violations and Civil 

Penalties 911 

Chapter 4.5. Intemiediate Care Facility/ 
Developmentally Disabled- 
Nursing 914 

Chapter 5. Referral Services 914 

Article 1 . Definitions 914 

Article 2. License 915 

Article 3. Administration 950 

Article 4. Services 950 

Article 5. Personnel Requirements 951 

Article 6. General Provisions 952 

Chapter 6. Home Health Agencies 952 

Article 1. Definitions 952 

Article 2. License 956 

Article 3. Services 959 

Article 4. Administration 962.2 

Article 5. Qualifications for Home 

Health Aide Certification 962.9 

Chapter 7. Primary Care Clinics 962.10 

Article 1. Definitions 962.10 

Article 2. License 963 

Article 3. Basic Services 964 

Article 4. Drug Distribution 965 

Article 5. Abortion Service 966 

Article 6. Administration 966 

Article 7. Physical Plant 968 

Article 8. Appeals Procedure 969 

Article 9. Birth Services 970 

Chapter 7.1. Specialty Clinics 971 

Article 6. Hemodialyzer Reuse 971 

Chapter 7.2. Psychology Clinics 977 

Article 1. Definitions 977 

Article 2. License 977 

Article 3. Basic Services 977 

Article 4. Administration 978 

Article 5. Physical Plant 980 

Chapter 8. Intermediate Care Facilities for 

the Developmentally Disabled 981 

Article 1 . Definitions 981 

Article 2. License 985 

Article 3. Services 990 

Article 4. Administration 1006 

Article 5. Physical Plant 1016 



Page xiv 



(7-18-2008) 



Title 22 



Social Security 
Page 

Violations and Civil Division 6. 

Penalties 1020 

Intermediate Care Facilities/ Chapter 1. 

Developmentally Disabled — Article 1 . 

Habilitative 1023 Article 2. 

Definitions 1023 Article 3. 

License 1025 Article 4. 

Services 1026 Article 6. 

Administration 1036 Article 7. 

Physical Plant 1042 ^^^^^^^ ^■ 

Violations and Civil 

Penalties 1044 Chapter 2. 

Psychiatric Health Facilities 1044 Subchapter 1 

Definitions 1044 Article 1 . 

Licensing and Inspection 1047 

^ . Article 2. 

Services 1049 

Article 3. 

Administration 1054 

Article 4. 

Physical Plant 1058.2 . . , _ 

Adult Day Health Centers 1058.2 

^ ^. . . Article 6. 

Defmitions 1058.2 

Article 7. 
License 1061 

Chapter 3. 
Services 1063 

Article 1. 
Administration 1068 

Article 2. 

Physical Plant 1072 . • . ^ 

Violations 1073 Article 4 

Chemical Dependency Recovery 

Hospital Licensing Regulations 1074 Article 5. 

Definitions 1074 ^"^^^^^ ^■ 

Article 7. 
Licensing and Inspection 1075 

Article 8. 
Basic Services 1077 

^ . ,c • Chapter 3.5. 

Optional Services 1080 

Article 1. 
Administration 1080 

Article 2. 

Physical Plant 1085 . . , „ 

Correctional Treatment Centers 1085 Article 4. 

Definitions 1085 

Article 5. 
Licensing and Inspection 1086.3 

Article 6. 

Required Services 1086.4 . . , ,, 

Optional Services 1086.13 _ 

Chapter 4. 

Administration 1086.20 a • i i 

Article 1. 

Physical Plant and Safety 1086.27 



Title Table of Contents 

Page 

Licensing of Community Care 
Facilities 1087 

General Licensing Requirements 1087 

General Definitions 1087 

License 1091 

Application Procedures 1092 

Administrative Actions 1103 

Continuing Requirements 1107 

Physical Environment 1119 

Incidental Medical 

Services 1 120 

Social Rehabilitation 

Facilities 1120.4 

Basic Requirements 1 120.4 

General Requirements and 

Definitions 1 120.4 

Licensing 1 120.5 

Applications Procedures 1 120.5 

Administrative Actions 1 120.6 

Enforcement Provisions 

(Reserved) 1 120.6 

Continuing Requirements 1 120.6 

Physical Environment 1120.11 

Adult Day Programs 1120.12 

General Requirements 1 120.12 

Licensing 1 120.16 

Application Procedures 1120.17 

Administrative Actions and 

Inspection Authority 1 120.25 

Enforcement Provisions 1 120.26 

Continuing Requirements 1120.28 

Physical Environment 1120.38 

Incidental Medical Services 1120.40 

Adult Day Support Center 1 120.44 

General Requirements 1120.44 

Licensing (Reserved) 1 120.44 

Application Procedures 1120.44 

Administrative Actions 

(Reserved) 1 120.44 

Civil Penalties (Reserved) 1120.44 

Continuing Requirements 1120.44 

Physical Environment 1 120.46 

Small Family Homes 1 120.46 

General Requirements and 

Definitions 1120.46 



Article 6. 
Chapter 8.5. 

Article \. 
Article 2. 
Article 3. 
Article 4. 
Article 5. 
Article 6. 

Chapter 9. 
Article 1. 
Article 2. 
Article 3. 
Article 4. 
Article 5. 

Chapter 10. 
Article 1 . 
Article 2. 
Article 3. 
Article 4. 
Article 5. 
Article 6. 

Chapter n. 

Article 1. 
Article 2. 
Article 3. 
Article 4. 
Article 5. 
Article 6. 

Chapter 12. 
Article 1. 
Article 2. 
Article 3. 
Article 4. 
Article 5. 
Article 6. 



Page XV 



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Title Table of Contents BARCLAYS CALIFORNIA 

Page 

Article 2. Licensing 1120.47 

Article 3. Application Procedures 1121 

Article 4. Administrative Actions 

(Reserved) 1121 

Article 5. Enforcement Provisions 1121 

Article 6. Continuing Requirements 1121 

Article 7. Physical Environment 1126.1 

Chapter 5. Group Homes 1126.2 

Article 1. General Requirements and 

Definitions 1126.2 

Article 2. Licensing 1129 

Articles. Application Procedures 1129 

Article 4. Administrative Actions 1131 

Article 5. Enforcement Provisions 1131 

Article 6. Continuing Requirements 1132 

Article 7. Physical Environment 1134.13 

Article 9. Administrator Certification 

Training Programs 1134.14 

Subchapter 1 . Community Treatment 

Facilities 1134.14(c) 

Article 1 . General Requirements and 

Definitions 1134.14(c) 

Article 2. Licensing (Reserved) 1134.14(d) 

Article 3. Application Procedures 1134.14(d) 

Article 4. Administrative Actions 1134.14(d) 

Article 5. Enforcement Provisions 1134.14(e) 

Article 6. Continuing Requirements .... 1134.14(e) 

Ardcle 7. Physical Environment Ii34.i4(i) 

Subchapter 2. Care for Children Under 

the Age of Six Years Ii34.i4(j) 

Article 1 . General Requirements and 

Definitions 1134.l4(j) 

Article 3. Application Procedures Ii34.i4(k) 

Article 6. Continuing Requirements ]l34.l4(k) 

Article 7. Physical Environment Il34.l4(r) 

Subchapter 3. Emergency Intervention in 

Group Homes Il34.i4(s) 

Article L General Requirements Ii34.i4(s) 

Article 3. Application Procedures Il34.i4(t) 

Article 6. Continuing Requirements 1134.17 

Subchapter 4. Transitional Shelter Care 

Facilities 1134.18 

Article L General Requirements 1134.18 

Article 2. License 1134.19 

Articles. Application Procedures 1134.19 



CODE OF REGULATIONS Title 22 

Page 

Chapter 6. AduU Residential Facilities 1134.20 

Article L General Requirements and 

Definitions 1134.20 

Article 2. Licensing 1134.22 

Articles. Application Procedures 1134.22 

Article 4. Administrative Actions 

(Reserved) 1134.22 

Article 5. Enforcement Provisions 1134.22 

Article 6. Continuing Requirements 1 134.22 

Article 7. Physical Environment 1140.2(b) 

Article 9. Administrator Certification 

Training Programs 1 140.4 

Chapter 7. Transitional Housing Placement 

Program 1140.7 

Article 1. General Requirements 1140.7 

Article 2. License Required 1140.8 

Articles. Application Procedures 1140.8 

Article 4. Administrative Actions 1 140.1 1 

Article 5. Enforcement Provisions 

(Reserved) 1140.12 

Article 6. Continuing Requirements 1140.12 

Article 7. Physical Environment 1140.18(a) 

Chapter 7.3. Crisis Nurseries 1140.19 

Article 1. General Requirements and 

Definitions 1140.19 

Article 2. License Required 1140.22 

Articles. Application Procedures 1140.25 

Article 4. Administrative Actions 1140.36 

Article 5. Enforcement Provisions 1 140.37 

Article 6. Continuing Requirements 1140.40 

Article 7. Physical Environment 1140.56 

Chapter 7.5. Foster Family Homes 1140.59 

Article L General Requirements and 

Definitions 1140.59 

Article 2. License 1140.59 

Article 3. Application Procedures 1141 

Article 4. Administrative Actions 1144 

Article 6. Continuing Requirements 1146 

Article 7. Physical Environment 1149 

Chapter 8. Residential Care Facilities for 

the Elderly (RCFE) 1149 

Article 1 . Definitions and Forms 1149 

Article 2. License 1154 

Article 3. Application Procedures 1158 

Article 4. Operating Requirements 1160 



Page xvi 



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Title 22 



Social Security 

Page 

Physicial Environment and Article 1. 

Accommodations J 167 

Background Check 1170 Article 2. 

Personnel 1174 Article 3. 

Resident Assessments, Article 4. 

Fundamental Services and Article 5. 

Rights 1178 

Chapter 10. 
Resident Records 1180.2(b) 

Food Services 1180.2(c) 

Health-Related Services and nivi«;ion 7 

Conditions l I80.2(i) 

Dementia ll80.2(s) 

Chapter 1. 
Enforcement l I80.2(y) 

Administrative Actions — Article 1 

General li80.2(z)(2) , , ^ 

Article 2. 

Administrator Certification *_• i -> 

. . ^ ^, , Articles. 

Trammg Programs — Vendor 

Information I180.2(z)(2) 

Article 4. 

Residential Care Facilities for Article 5 

the Chronically 111 ]i80.2(z)(6) 

Article 6. 
License ll80.2(z)(6) 

Definitions 1180.2(z)(6) 

Application Procedures 1180.4 Article 7. 

Administrative Actions 1180.15 Articles. 

Enforcement Provisions 1180.16 Article 9. 

Article 1 
Continuing Requirements H80.19 ^m^ic lu. 

nu • 1 T- • ^ .,„^ Article II. 

Physical Environment 1180.25 

Article 12 
Medical and Health Related 

Care 1180.27 

Foster Family Agencies 1 180.37 Chapter 2 

General Requirements and 

Definitions 1180.37 Article 1 

License 1180.38 Article 2. 

Application Procedures 1 180.38 

Certification and Use of Chapter 3. 

Homes 1182 

Administrative Actions 1182.1 Article!. 

Complaints 1182.2 Article 2. 

Continuing Requirements 1182.2 Article 3. 

Physical Environment 1182.8(a) Article 4. 

Article 5. 
Adoption Agencies 1182.9 

License 1182.9 Article 6. 

Administration 1182.10 ^, ^ . 

Chapter 4. 

Foster Family Homes 1182.14 Article I. 



Title Table of Contents 

Page 

General Requirements, 

Definitions, and Forms 1182.14 

Administrative 1 185 

License/ Approval Standards 1186.8 

Placement 1186.14 

Special Health Care Needs 11 86. 1 6 

Regulations Regarding 

Supervision of Life Care 

Contracts 1186.19 

Health Planning and Facility 
Construction 1191 

Health Planning and Resources 
Development 1191 

Definitions 1191 

Advisory Health Council 1193 

Area Health Planning 

Agencies 1195 

Office Functions 1 195 

Certificate of Need 1 196 

Hearing Procedure on 

Applications for a 

Certificate of Need 1198 

Appeals 1199 

Certificate of Exemption 1200 

Terms and Conditions 1200 

Development of Plans 1201 

Review Criteria 1202 

Procedures and Requirements 
Relating to the Cahfornia 
Environmental Quality Act 1204 

Eminent Domain Procedures for 
Nonprofit Hospitals 1205 

Definitions 1205 

General Provisions and 

Procedures 1206 

Freestanding Cardiac 

Catheterization Pilot Project 1208 

General Provisions 1208 

Monitoring 1209 

Fees 1210 

Operational Requirement 1210 

Compliance with Other Laws 

and Regulations 1210 

Definitions 1211 

Fire Protection Loans 1211 

Definitions 1211 



Article 5. 



Article 6. 


Article 7. 


Article 8. 


Arficle 9. 


Article 10 


Article 11 


Article 12 


Article 13 


Article 14 


Article 15 



Chapter 8.5. 

Article 1 
Article 2 
Article 3 
Article 4 
Article 5 
Arficle 6 
Article 7 
Arficle 8 

Chapter 8.8. 
Arficle 1. 

Article 2. 
Arficle 3. 
Arficle 4. 

Arficle 5. 
Article 6. 
Arficle 7. 
Article 8. 

Chapter 9. 
Arficle 1. 
Arficle 2. 

Chapter 9.5. 



Page xvii 



(7-18-2008) 



Title Table of Contents BARCLAYS CALIFORNIA 

Page 

Article 2. General Provisions 121] 

Chapter 5. Health Facility Construction 

Loan Insurance 1214 

Article 1. Definitions 1214 

Article 2. General Provisions 1216 

Article 3. California Health Facilities 
Construction Loan Insurance 
Program — State Plan 1220 

Article 4. Defaults 1220 

Article 5. Termination of Insurance 1220 

Article 6. Health Facility Construction 

Loan Insurance Fund 1220 

Article 7. California Health Facihties 
Construction Loan Insurance 
Program — State Plan 1220 

Chapter 6. Health Workforce Pilot Project 

Program 1220 

Article 1. Definitions 1220 

Article 2. Minimum Standards 1221 

Article 3. Application Procedure 1221 

Article 4. Content of Application 1222 

Article 5. Application Review Process 1224 

Article 6. Project Approval 1224 

Article 7. Program ResponsibiUties 1224 

Article 8. Project Completion/ 

Termination 1225 

Chapter 7. Seismic Structural Safety 

Standards 1226 

Article 1 . General Provisions 1226 

Article 2. Definitions 1226 

Article 3. Approval of Drawings and 

Specifications 1226.1 

Article 4. Fees 1226.2 

Articles. Approval of Construction 1226.2 

Article 6. Appeals Procedures of the 

Building Safety Board 1227 

Article 7. General Design Requirements 

(Testing and Inspection) 1227 

Article 8. Masonry (Testing and 

Inspection) 1227 

Article 9. Wood (Testing and 

Inspection) 1227 

Article 10. Concrete (Testing and 

Inspection) 1227 

Article 11. Steel and Iron (Testing and 

Inspection) 1228 



CODE OF REGULATIONS Title 22 

Page 

Article 12. Aluminum (Testing and 

Inspection) 1228 

Article 13. Excavations, Foundations and 
Retaining Walls (Testing 
and Inspections) 1228 

Article 14. Veneer (Testing and 

Inspection) 1228 

Article 15. Masonry or Concrete 

Chimneys, Fireplaces and 

Barbecues (Testing and 

Inspection) 1228 

Article 16. Contracts 1228 

Chapter 8. Clinic Renovation (Construction) 

Grant and Loan Program 1228 

Article 1. Definitions 1228 

Article 2. Eligibility 1229 

Article 3. Types of Assistance 1229 

Article 4. General Provisions 1229 

Article 5. Application for Funds 1229 

Article 6. Selection Process 1229 

Article 7. Administration 1230 

Chapter 9. Hospital Charges and Fair 

Pricing Policies Reporting 1230 

Article 1. Hospital Charge Description 

Master Reporting 1230 

Article 2. Hospital Fair Pricing 

Pohcies Reporting 1231 

Chapter 10. Health Facility Data 1232 

Article 1. General 1232 

Article 2. Accounting System 

Requirements 1233 

Article 3. Reporting Requirements 1235 

Article 4. Modification, Extension, and 

Appeal Processes 1236 

Article 5. Collection of Special Fees 1236.2 

Article 6. Public Availability of 

Disclosure Materials 1237 

Article 7. CABG Data Reporting 

Requirements 1237 

Article 8. Patient Data Reporting 

Requirements 1238.7 

Chapter 11. Alzheimer's Disease Institute 

Demonstration Project 1251 

Subchapter 1. Definitions 1251 

Subchapter 2. General Requirements 1263 

Article 1. Institute Administration 1263 

Article 2. Patient Services Management 1267 



• 



Page xviii 



(7-18-2008) 



Title 22 



Social Security 
Page 

Staff 1283 Subchapter 9. 

Environmental Safety and 

Health 1288 Article 1 . 

Physical Plant 1289 Article 2. 

Standards for All Types of Article 3. 

Services 1295 Article 4. 

Monitoring and Comphance 1295 Article 5. 

Skilled Nursing Services 1297 Subchapter 10. 

Definitions 1297 Article 1 . 

Designation 1297 Article 2. 

Required Services 1297 Article 3. 

Administration 1301 Article 4. 

Intermediate Care Article 5. 

Services 1301 Subchapter 1 1 . 

Definitions 1301 Article 1. 

Designation 1301 Article 2. 

Services 1302 Article 3. 

Administration 1303 Article 4. 

Outpatient Care Article 5. 

Definitions 1303 Article 6. 

Definitions 1303 Article 7. 

Designation 1304 Subchapter 12. 

Basic Services 1304 

Article 1 
Drug Distribution 1305 

, J . . Article 2. 

Admmistration 1306 

Article 3. 
Day Health Care Services 1306 

Definitions 1306 Article4. 

Designation 1307 Subchapter 13. 

Services 1307 Article 1. 

Administration 1309 Article 2. 

Physical Plant I3ll Article 3. 

Social Day Care Services 1311 Article 4. 

Definitions nil Chapter 12. 

Administration I3il 

Patient Services 1312 Article 1 . 

Designation 1313 Article 2. 

Home Health Care Article 3. 

Services 1313 Article 4. 

Definitions 1313 Article 5. 

Designation 1313 Article 6. 

Services 1314 Article 7. 

Administration 13I6 Article 8. 

Qualifications for Home Chapter 13. 

Health Aide Certification 1317 



Title Table of Contents 

Page 

In-Home Supportive 

Services 1318 

Definition 1318 

Designation 1318 

Services 1318 

Staff 1319 

Administration 1319 

Respite Care Services 1319 

Definitions 1319 

Training 1320 

Administration 1320 

Services 1320 

Designation 1320 

Hospice Care Services 1321 

Definitions 1321 

Required Services 1321 

Staff 1322 

Continuity of Care 1323 

Other Services 1324 

Administration 1325 

Designation 1325 

Residential Care 

Services 1325 

Definitions 1325 

Designation 1 325 

Administration and Staffing 
Requirements 1325 

Basic Services 1326 

Referral Services 1329 

Definitions 1329 

Designation 1329 

Administration 1329 

Services 1330 

Postsurgical Recovery Care 
Demonstration Project 1330 

Definitions 1330 

Required Services 1335 

General Requirements 1339 

Administration 1341 

Fees 1345 

Operational Requirements 1345 

Monitoring and Compliance 1345 

Physical Plant 1346.1 

Mobile Cardiac Catheterization 

Pilot Project 1347 



Article 3. 
Article 4. 

Article 5. 
Article 6. 

Article 7. 
Subchapter 3. 

Article I. 

Arficle 2. 

Article 3. 

Article 4. 
Subchapter 4. 

Article 1. 
Article 2. 
Arficle 3. 
Article 4. 
Subchapter 5. 

Article 1. 

Article 2. 

Article 3. 

Arficle 4. 

Arficle 5. 
Subchapter 6. 

Article 1. 

Arficle 2. 

Article 3. 

Article 4. 

Arficle 5. 
Subchapter 7. 

Article 1. 

Arficle 2. 

Article 3. 

Arficle 4. 
Subchapter 8. 

Article I. 
Arficle 2. 
Article 3. 
Arficle 4. 
Article 5. 



Page xix 



(7-18-2008) 



Title Table of Contents BARCLAYS CALIFORNIA 

Page 

Article I . Definitions 1347 

Article 2. Relationship Between Base 
and Host Hospital During 
Pilot Program Operation 1347 

Article 3. General Provisions 1347 

Article 4. Interim Program Use of 

Mobile Lab When Replacing a 
Hospital Based Cardiac 
Catheterization Laboratory 1348 

Article 5. Monitoring and Record 

Keeping 1348 

Article 6. Fees 1348 

Article 7. Operational Requirement 1348 

Article 8. Compliance with Other Laws 

and Regulations 1348 

Chapter 14. Minority Health Professions 

Education Foundation 1349 

Article 1. Definitions 1349 

Article 2. General Provisions 1352.3 

Article 3. Scholarships 1352.4 

Article 4. Loan Repayment Program 1352.6 

Article 5. Registered Nurse Education 

Program 1352.6 

Article 6. Appeals 1352.7 

Article 7. Citizenship and Alien 

Verification Requirements 1352.8 

Chapter 15. Associate Degree Nursing 

Scholarship Program 1352.15 

Chapter 1 6. Vocational Nurse Scholarship and 

Loan Repayment Program 1352.17 

Article 1. General Provisions 1352.17 

Article 2. Scholarship Program 

Provisions 1352.18 

Article 3. Loan Repayment Program 

Provisions 1352.20 

Chapter 17. Licensed Mental Health Service 

Provider Education Program 1352.21 

Division 8. Nondiscrimination in State- 
Supported Programs and 
Activities 1353 

Chapter 1. Purpose, General Definitions and 

General Provisions 1353 



CODE OF REGULATIONS Title 22 

Page 

Article 1. Purpose and General 

Provisions 1353 

Article 2. General Definitions 1354 

Article 3. Apphcability 1354 

Chapter 2. Discriminatory Practices 
Relating to All Groups 
Protected by Article 9.5 1355 

Article 1. General Prohibitions Against 

Discrimination 1355 

Article 2. Mandatory and Permissive 

Remedial Action 1 355 

Chapter 3. Discriminatory Practices 

Relating to Specific Groups 

Protected by Article 9.5 1356 

Article 1 . Purpose of This Chapter 1356 

Article 2. Color and Ethnic Group 

Identification 1356 

Article 3. Rehgion 1356 

Article 4. Age 1356 

Article 5. Sex 1357 

Article 6. Physical or Mental 

Disabihly 1358 

Chapter 4. Compliance and Enforcement 1359 

Article 1. State Agency Enforcement 

System 1359 

Article 2. Compliance Reports and 

Compliance Information 1360 

Article 3. Information to 

Beneficiaries, the Public, 

Recipients and Employees on 

Rights and 

Responsibihties 1360 

Article 4. Compliance Reviews and 

Complaints 1361 

Article 5. Hearing Process 1362 

Article 6. Sanctions 1363 

Article 7. Enforcement System 
Evaluation and 
Coordination 1363 

Chapter 5. Relationship Between the 

Secretary, DFEH and FEHC 1363 

Article 1. Incorporation of DFEH and 
FEHC Employment 
Discrimination Regulations 
by Reference 1363 

Article 2. State Agency, DFEH and FEHC 

Roles 1363 



Page XX 



(7-18-2008) 



Title 22 



Social Security 

Page 

Prehospital Emergency Medical Article 2. 

Services 1365 Article 3. 

Emergency Medical Services 

Authority and Commission on Article 4. 

Emergency Medical Services — Article 5. 

Conflict of Interest Code 1365 

Training Standards for Child 

Care Providers 1365 Article 6. 

Definitions 1365 Chapter 3. 

Training Requirements for 

Child Care Providers 1366.2 Article 1 . 

Training Program Approval 1366.2 Article 2. 

Training Program Director Article 3. 

and Instructor 

Requirements 1366.2(a) Article 4. 

Course Hours and Class Article 5. 

Requirements 1366.2(c) Article 6. 

Class Rosters, Course Chanter 4 

Completion Documents and 

Stickers 1366.2(d) . ■ , . 

Article 1. 

'^^^'^ "«"<=» Artide2. 

First Aid Testing for School Bus Article 3. 

Drivers 1366.3 

Definitions 1366.3 

General 1366.3 Article 4. 

Examination Standards 1366.3 

Article 5. 

First Aid Standards for Public Article 6. 

Safety Personnel 1366.3 a • i -r 

■' Article 7. 

Definitions 1366.3 Article 8. 

General Training Provisions 1366.4 Article 9 

Training Standards 1366.4 

Training Approval Options 1368 Chapter 5. 

Training Standards and 

Utilization for Use of the Chapter 6. 

Automated External 

Defibrillator by Non-Licensed 

or Non-Certified Personnel 1369 Article 1 

Definitions 1369 Article 2. 

General Training Provisions 1369 Article 3. 

AED Training Program 

Requirements 1370 Article 4. 

Operational AED Service 

ProviderA^endor Article 5. 

Requirements 1370 „, _ 

Emergency Medical Article 1 . 

Technician I 1371 Article 2. 

Definitions 1371 



Title Table of Contents 
Page 

General Provisions 1372 

Program Requirements for EMT- 

I Training Programs 1377 

EMT-I Certification 1380 

Maintaining EMT-I 

Certification and 

Recertification 1380. 1 

Record Keeping and Fees 1380.2 

Emergency Medical 

Technician-II 1380.2 

Definitions 1380.2 

General Provisions 1380.3 

Program Requirements for EMT- 

II Training Programs 1382 

Certification 1387 

Operational Requirements 1388 

Record Keeping and Fees 1389 

Emergency Medical Technician- 
Paramedic 1390 

Definitions 1390 

General Provisions 1392 

Program Requirements for 

Paramedic Training 

Programs 1394 

Applications and 

Examinations 1399 

Licensure 1400 

License Renewal 1402 

System Requirements 1402 

Record Keeping and Fees 1402.2 

Discipline and Reinstatement 

of License 1402.3 

Process for Applicant 

Verification 1402.5 

Process for EMT-I and EMT-II 

Certification Disciplinary 

Action 1402.8 

Definitions 1402.8 

General Provisions 1403 

Evaluation and 

Investigation 1406 

Determination and 

Notification of Action 1406 

Local Responsibilities 1406.2 

Trauma Care Systems 1406.3 

Definitions 1406.3 

Local EMS Agency Trauma 

System Requirements 1408 



Division 9. 

Chapter 1. 

Chapter 1.1. 

Article 1. 
Article 2. 

Article 3. 
Article 4. 

Article 5. 
Article 6. 

Article 7. 
Chapter 1.2. 

Article 1. 
Article 2. 
Article 3. 

Chapter 1.5. 

Article 1. 
Article 2. 
Article 3. 
Article 4. 

Chapter 1.8. 



Article 1. 
Article 2. 
Article 3. 

Article 4. 



Chapter 2. 
Article 1. 



Page xxi 



(7-18-2008) 



Title Table of Contents BARCLAYS CALIFORNIA 

Page 

Article 3. Trauma Center Requirements 1410 

Article 4. Quality Improvement 1414.2 

Articles. Transfer of Trauma Patients 1414.2 

Chapter 8. Prehospital EMS Aircraft 

Regulations 1414.3 

Article 1. Definitions 1414.3 

Article 2. General Provisions 1414.4 

Article 3. Personnel 1415 

Article 4. System Operation 1415 

Article 5. Equipment and Supplies, 

Aircraft Specifications 1415 

Chapter 9. Poison Control Center 

Regulations 1416 

Article 1. Definitions 1416 

Article 2. General Provisions 1416 

Article 3. Designation Process 1416.2 

Chapter 11. EMS Continuing Education 1416.3 

Article 1. Definitions 1416.3 

Article 2. Approved Continuing 

Education 1416.4 

Article 3. Continuing Education 

Records 1416.4 

Article 4. CE Provider Approval 

Process 1416.5 

Article 5. CE Provider Denial/ 

Disapproval Process 1416.5 

Article 6. CE Providers for EMS 

Personnel 1416.5 

Chapter 12. EMS System Quality 

Improvement 1416.7 

Article 1 . Definitions 1416.7 

Article 2. EMS Service Provider 1416.7 

Article 3. Paramedic Base Hospital 1416.7 

Article 4. Local EMS Agency 1416.8 

Article 5. EMS Authority 1416.8 

Division 10. California Medical Assistance 

Commission 1417 

Chapter 1. Introduction 1417 

Article 1. Definitions 1417 

Article 2. Commission Meetings 1417 

Article 3. Commission Staff 1417 

Chapter 2. Negotiation and Approval of 

Proposed Contracts 1417 



CODE OF REGULATIONS Title 22 

Page 

Chapter 3. Confidentiality of Contract 

Negotiations 1418 

Chapter 4. Conflict of Interest Code 1418 

Division 11. Department of Community 

Services and Development 1421 

Chapter 1. Community Services Block Grant 

Regulations 1421 

Chapter 2. Low-Income Home Energy 

Assistance Program Regulations — 1428 

Chapter 3. Applicant Verification 

Regulations 1428.5 

Chapter 4. Naturalization Services 

Regulations 1428.8 

Chapter 5. Department of Community Services 
and Development — Conflict of 
Interest Code 1428.8 

Division 12. Child Care Facility Licensing 

Regulations 1429 

Chapter 1. Child Care Center General 

Licensing Requirements 1429 

Article 1. General Requirements and 

Definitions 1429 

Article 2. Licensing 1431 

Article 3. Application Procedures 1432 

Article 4. Enforcement Provisions 1441 

Article 5. Administrative Actions 1444 

Article 6. Continuing Requirements 1445 

Article 7. Physical Environment 1451 

Subchapter 1 . (Reserved) 1454 

Article 1. General Requirements and 

Definitions 1454 

Article 2. Licensing 1454 

Article 3. Application Procedure 1454 

Article 4. Administrative Actions 1454 

Article 5. Enforcement Provisions 

(Reserved) 1454 

Article 6. Continuing Requirements 1454 

Article 7. Physical Environment 1456 

Subchapter 2. Infant Care Center 1456 

Article 1 . General Requirements and 

Definitions 1456 

Article 2. Licensing (Reserved) 1456 

Article 3. Apphcation Procedures 

(Reserved) 1456 

Article 4. Enforcement Provisions 

(Reserved) 1456 



Page xxii 



(7-18-2008) 



Title 22 



Social Security 

Page 

Administrative Actions Article 4. 

(Reserved) 1456 

Continuing Requirements 1456 Article 5. 

Physical Environment 1456.4 Article 6. 

School-Age Child Care Article 7. 

Center 1456.6 Subchapter 2. 

General Requirements and 

Definitions 1456.6 Subchapter 3. 

Licensing (Reserved) 1456.6 

Application Procedures 1456.6 Article 1. 

Enforcement Provisions Chapter 2. 

(Reserved) 1456.6 Article 1 . 

Administrative Actions Article 2. 

(Reserved) 1456.6 

Continuing Requirements 1456.6 Article 3. 

Child Care Center for 

Mildly 111 Children 1456.8 Article 4. 

General Requirements and Article 5. 

Definitions 1456.8 Article 6. 

Licensing 1456.9 Chapter 3. 

Apphcation Procedures 1456.9 Article 1 

Administrative Actions Article 2. 

(Reserved) 1456.10 

Enforcement Provisions Chanter 4 

(Reserved) 1456.10 

Continuing Requirements 1456.10 

Chapter 5. 
Physical Environment 1456.15 

Family Day Care Homes for Chapter 6. 

C™'"^" ^456.17 ^^^j^i^i 

General Requirements and Subchapter 6. 1 

Definitions 1456.17 

Licensing 1456.18 Article 1 

Application Procedure 1457 Article 2. 

Enforcement Provisions 1463 

Administrative Actions 1464.1 Article 3. 

Continuing Requirements 1465 Article 4. 

Physical Environment Chapter 7. 

(Reserved) 1466.5 Article 1. 

Department of Child support ^™^''=2 

Services 1467 Article 3. 

Article 4. 
Program Administration 1467 

Operations 1467 Article 5. 

Definitions 1467 

(Reserved) 1472.10(a) Article 6. 

Plans of Cooperation 1472.10(a) Chapter 8. 



Title Table of Contents 

Page 

Standards for Local Program 
Operations (Reserved) 1472.10(b)(1) 

Records Management 1472.10(b)(1) 

Customer Service 1472.10(b)(2) 

Staff Requirements 1472.10(b)(3) 

Fiscal Administration 

(Reserved) 1472.10(b)(4) 

Administrative 

Reporting 1472.10(b)(4) 

Administrative Reports 1472.10(b)(4) 

Case Intake 1472.10(b)(5) 

Definitions 1472.10(b)(5) 

Application and 

Reitrral 1472.10(b)(6) 

Case Opening 

Requirements 1472.10(b)(6) 

Case Processing 1472.10(b)(7) 

Cooperation 1472.10(b)(8) 

Family Violence 1472.10(b)(9) 

Locate 1472.10(c) 

Locate Requirements 1472.10(c) 

Federal Parent Locator 

Service 1472.10(d) 

Establishing Paternity 

(Reserved) 1472.10(e) 

Review and Adjustment of 

Child Support Orders 1472.10(e) 

Enforcement Actions I472.l0(i) 

Definitions 1472. 10(i) 

Immediate Enforcement 

Actions 1472. 10(j) 

Income Withholding Orders . . . I472.i0(j) 

Medical Support 

Enforcement 1472. I0(k) 

Real Property Liens I472.i0(m) 

Credit Reporting 1472. I0(o) 

Interstate Cases I472.i0(p) 

Definitions 1472. I0(p) 

Long Arm Jurisdiction 1472.12 

General Provisions 1472.12 

California As Initiating 

State 1472.14 

California As Responding 

State 1472.16 

Limited Interstate Services 1472.17 

Case Closure 1472.17 



Article 5. 

Article 6. 

Article 7. 

Subchapter 3 

Article 1. 

Article 2. 
Article 3. 
Article 4. 

Article 5. 

Article 6. 
Subchapter 4 

Article 1. 

Article 2. 
Article 3. 
Article 4. 

Article 5. 



Article 6. 


Article 7. 


Chapter 3. 


Article 1. 


Article 2. 


Article 3. 


Article 4. 


Article 5. 


Article 6. 


Article 7. 


Division 13. 


Chapter 1. 


Subchapter 1 


Article 1. 


Article 2. 


Article 3. 



Page xxiii 



(7-18-2008) 



Title Table of Contents 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



Page 

Article 1. Definitions 1472.17 

Article 2. Case Closure 1472.18 

Chapter 9. Collection and Distribution of 

Child Support 1472.20 

Article 1 . Delinitions 1472.20 

Article 5. General Requirements 1472.21 

Article 6. Compromise of Assigned 

Arrearages — Family 

Reunification 1472.21 

Chapter 10. Complaint Resolution 1472.23 



Page 

Article 1. Definitions 1472.23 

Article 2. Local Complaint Resolution 

Process 1472.24 

Article 3. State Hearing 1475 

Chapter 11. Quahty Control 1483 

Article 1. Performance Measures 1483 

Chapter 12. Automation Requirements 

(Reserved) 1483 

Chapter 13. Conflict of Interest Code 1485 



Page xxiv 



(7-18-20 



.m. 



Barclays Official 

California 

Code of 
Regulations 



Title 22. Social Security 

Division 7. Health Planning and Facility Construction 



Vol. 31 



XHOIVISOM 

^^ 

WEST 



Barclays Official California Code of Regulations 

425 Market Street • Fourth Floor • San Francisco, CA 94105 
800-888-3600 



Title 22 



Health Planning and Facility Construction 



Table of Contents 



Division 7. Health Planning and Facility Construction 



Table of Contents 



Page 



Page 



Chapter 1. 



Article 1. 

4} 90001. 
§ 90002. 
§ 90003. 
§ 90005. 
§ 90007. 
§ 90009. 
§ 90009.5. 
§ 90010. 
§90011. 
§90013. 
§90015. 
§ 90017. 
§ 90019. 
§90021. 
§ 90023. 
§ 90025. 
§ 90027. 
§ 90029. 
§90031. 
§ 90032. 
§ 90033. 
§ 90035. 
§ 90037. 
§ 90038. 
§ 90039. 
§ 90041. 
§ 90043. 
§ 90044. 
§ 90045. 
§ 90046. 
§ 90047. 
§ 90049. 
§90051. 
§ 90052. 
§ 90053. 
§ 90057. 
§ 90058. 
§ 90059. 

§ 90060. 
§ 90061. 

§ 90063. 

Article 2. 

§90101. 
§ 90103. 

§90105. 
§ 90107. 

§ 90109. 

§90110. 

§90111. 

Article 3. 



Health Planning and Resources 
Development 1191 

Definitions 1191 

Addition. 

Applicant. 

Application. 

Adjacent. 

Area Agency. 

Area Plan. 

Capital Expenditure Threshold. 

Cardiovascular Surgery Service. 

Certified Cost Estimate. 

Certificate of Exemption. 

Certificate of Need. 

Community Need. 

Conmiencement of Construction. 

Comparable Arrangement. 

Consumer. 

Council. 

Days. 

Department. 

Director. 

Division. 

Effective Date. 

Facility. 

Facility Health Resources. 

Functionally Related. 

Health Facility. 

Health Planning Area. 

Health Systems Agency. 

Immediately Adjacent. 

Local Area. 

Local Agency. 

Modernization. 

Person. 

Provider. 

Replacement. 

Service Area. 

Services. 

Specialty Clinic. 

Statewide Health Facilities and 

Services Plan. 

Undertake. 

Voluntary Area Health Planning 

Agency. 

Voluntary Local Health Planning 

Agency. 

Advisory Health Council 1193 

Council Functions. 

Designation of Health Planning 

Area. 

Designation of Area Agency. 

Criteria for Designation of Area 

Agencies. 

Criteria for Evaluation of Area 

Agencies. 

Nondiscrimination and Affirmative 

Action. 

Approval of Local Health Planning 

Areas. 



§ 90201 . Area Agency Functions. 

Article 4. Office Functions 1 195 

§ 90301 . Functions of the Department. 

§ 90303. Responsibilities Relating to 

Statewide Policies. 
§ 90304. Plan Development Guidelines. 

§ 90305. Policies for Facility and Services 

Planning. 
§ 90307. Policies Relating to Health 

Facilities. 
§ 90309. Statewide Pohcies for General 

Acute Care. 
§ 90311. Statewide Policies for Acute 

Psychiatric Care. 
§ 90313. Statewide Policies for Special and 

Supplemental Services. 
§ 90315. Statewide Policies for Health 

Facilities Providing Long-Term 

Care. 
§ 90317. Statewide Method for Calculating 

Resource Requirements. 



Area Health Planning 
Agencies 



1195 



Article 5. 


Certificate of Need 1196 


§ 90401. 


Projects Requiring a Certificate of 




Need. 


§ 90403. 


Projects Exempt from Certificate of 




Need Review Procedures. 


§ 90407. 


Projects Necessary Because of 




Disaster or Other Emergency. 


§ 90409. 


Projects to Comply with Law or 




Regulation. 


§90411. 


Projects Under the Capital 




Expenditure Threshold. 


§ 90412. 


Establishment and Adjustment of 




the Capital Expenditure Threshold. 


§ 90413. 


Notice of Intent. 


§ 90415. 


Application Fee. 


§ 90416. 


Fee for Preparation of EIR or 




Negative Declaration. 


§90417. 


Special Fees. 


§ 90419. 


Application Submission. 


§ 90420. 


Projects Not Directly Related to 




Patient Care. 


§90421. 


Incomplete Application. 


§ 90422. 


Projects for Sole Community 




Providers or Long Term Care. 


§ 90423. 


Complete Application. 


§ 90425. 


Verification of Certified Cost 




Estimates. 


§ 90427. 


Public Inspection. 


§ 90429. 


Amendments to Applications. 


§90431. 


Withdrawal of Applications. 


§ 90433. 


Area Agency Review. 


Article 6. 


Hearing Procedure on 




Applications for a 




Certificate of Need 1198 


§90501. 


Time and Place of Hearing. 


§ 90503. 


Notice of Hearing. 


§ 90504. 


Informal Hearings. 


§ 90505. 


Service of Papers. 


§ 90507. 


Parties. 


§ 90509. 


Obligations of the Parties Prior to 




the Hearing. 


§90511. 


Requests for Depositions. 



Page i 



(1-18-2008) 



Table of Contents 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



J^ 90512. 
§90513. 
§90515. 
$90517. 

Article 7. 

§90551. 
§ 90553. 
§ 90555. 
§ 90557. 
§ 90559. 
§90561. 
§ 90563. 
§ 90565. 
§ 90567. 

Article 8. 

§90601. 
§ 90603. 



§ 90605. 



§ 90607. 



§ 90608. 


§ 90609. 


Article 9. 


§90701. 


§ 90703. 


§ 90704. 


§ 90705. 


§ 90705.1 


§ 90707. 


Article 10. 


§90801. 


§ 90803. 


§ 90807. 


§ 90809. 


§90811. 


§90813. 


§ 90815. 


§ 90819. 


§ 90821. 


§ 90823. 


Article 11. 


§90901. 


§ 90902. 


§ 90903. 



§ 90904. 



§ 90905. 

§ 90906. 
§ 90907. 



Page 

Witnesses and Subpoenas. 

Hearing Procedure. 

Basis for Decisions on Projects. 

Decisions. 

Appeals 1199 

Appeals. 

Appeal Filing Procedures. 
Service of Papers. 
Certification of Oral Arguments. 
Notice of Hearing. 
Appeal Hearing Procedure. 
Notice of Meeting. 
Decisions on Appeal. 
Disqualification. 

Certificate of Exemption 1200 

Types of Exempt Projects. 

Projects Not Subject to Review by a 

Voluntary Area Health Planning 

Agency. 

Projects Previously Decided by a 

Voluntary Area Health Planning 

Agency. 

Exemption Requests for 

Remodeling and Replacement 

Projects. 

Facility Serving an Underserved 

Population. 

Delineation of Services and 

Departments Within Health 

Facilities. 

Terms and Conditions 1200 

Notice of Decision. 
Effective Date of Final Decisions. 
Transferability of Certificates. 
Expiration of Certificates. 
Extensions Necessitated by 
Uncertainty of Government 
Revenue Source. 
Revocation of Certificates. 

Development of Plans 1201 

Area Plans. 

Data and Methods of Area Plans. 

General Requirements for 

Recominended Actions. 

Area Agency Alternative Methods 

and Rates. 

Health Facility Planning Areas. 

Inventory and Utilization Data of 

Health Resources. 

Population to Be Used in Area 

Planning. 

Statewide Health Facilities and 

Services Plan. 

Procedures for Adoption of Area 

Plans. 

Adoption of Statewide Health 

Facilities and Services Plan. 

Review Criteria 1202 

Criteria for Determining the 

Desirability of Projects. 

Criteria for Projects Not Directly 

Related to Patient Care. 

Criteria for Comprehensive Group 

Practice Prepayment Health Care 

Service Plans. 

Criteria for Equipment Replacement 

Projects Not Exempt Under Section 

90607 Solely Because of Section 

90607(c)(6). 

Criteria for Projects for Which 

Special Justification is Claimed. 

Review of Compefing Applications. 

Criteria for a Bum Center. 



§ 90909. 

§90911. 

§90913. 

§ 90915. 

§90917. 

§90919. 

§90921. 
§ 90923. 

§ 90925. 

§ 90927. 
§ 90929. 

§90931. 
Article 12. 



§ 90950. 
§ 90952. 

§ 90955. 
§ 90957. 
§ 90962. 



Chapter 2. 



Page 

Criteria for Cardiovascular Surgery 

Service. 

Criteria for Chionic Dialysis 

Stations. 

Criteria for a Computerized 

Tomography (CT) Scanner. 

Criteria for Emergency Medical 

Service, Basic. 

Criteria for Emergency Medical 

Service, Comprehensive. 

Criteria for Intensive Care Newborn 

Nursery Service. 

Criteria for Psychiatric Service. 

Criteria for Radiation Therapy 

Service. 

Criteria for Renal Transplant 

Service. 

Criteria for Surgical Clinics. 

Criteria for a Basic, Supplemental, 

Required or Opfional Service. 

Criteria for a Capital Expenditure. 

Procedures and Requirements 
Relating to the California 
Environmental Quality Act 1204 

Statement of Policy. 

General Procedures Relating to 

CEQA. 

Categorical Exemption. 

Ministerial Projects. 

Requirements for Office Acting As 

Responsible Agency. 

Eminent Domain Procedures for 
Nonprofit Hospitals 1205 



Article 1. 


Definitions 


§91001. 


Certificate of Necessity. 


§ 91003. 


Department. 


§ 91005. 


Director. 


§ 91007. 


Final Environmental Impact Report. 


§ 91009. 


Interested Party. 


§91011. 


Nonprofit Hospital. 


§91013. 


Owners of Real Property Affected. 


Article 2. 


General Provisions and 




Procedures 


§91015. 


Applicability. 


§91017. 


Existing Facility Application for 




Certificate of Necessity. 


§91019. 


New Facility Applicafion for 




Certificate of Necessity. 


§91021. 


Public Hearing. 


§91023. 


Action upon Applicafion. 



1206 



Chapter 3. Freestanding Cardiac 

Catheterization Pilot Project 1208 

Article 1. General Provisions 1208 

§91100. Spatial Requirements. 

§ 9 1 1 02. Staffing Requirements. 

§ 91104. Equipment Requirements. 

§ 91 106. Drug Requirements. 

§ 91108. Emergency Protocol Requirements. 

§ 91110. Internal Patient Safety Assurance 

Procedures. 
§ 9 1 1 1 2. Criteria for the Selection and 

Exclusion of Patients. 
§ 9 1 11 4. Permitted Procedures and 

Minimums. 
§91116. Written Informed Consent. 

Article 2. Monitoring 1209 

§ 91120. Data and Pafient Utilization. 

§ 91 122. Access to Records and Facility Site. 



Page ii 



(1-18-2008) 



Title 22 



Health Planning and Facility Construction 



Table of Contents 



• 



§91124. 
§91126. 
§91128. 

Article 3. 

§91130. 

Article 4. 

§91140. 

Article 5. 

§91150. 

Article 6. 

§91160. 

Chapter 4. 

Article 1. 

§91301. 
§ 91303. 
§91305. 
§91307. 
§91309. 
§91311. 
§91313. 

Article 2. 

§91314. 
§91315. 
§91317. 
§91319. 
§91321. 
§91323. 
§91325. 
§91327. 
§91329. 
§91331. 
§91333. 
§ 91335. 
§ 91337. 

§91339. 
§91341. 
§ 91343. 

Chapter 5. 



Page 

Reasons for 

SuspendingAVithdrawiiig Project 

Approval. 

Methods of 

SuspendingAVithdrawing Project 

Approval. 

Hearing Procedure. 

Fees 1210 

Fee. 

Operational Requirement 1210 

Operational Requirement. 

Compliance with Other Laws 

and Regulations 1210 

Compliance with Other Laws and 

Regulations. 

Definitions 1211 

Definitions. 

Fire Protection Loans 121 1 

Definitions 1211 

Basic Services. 

Construction Costs. 

Department. 

Facility. 

Housing for the Aged. 

Project Property. 

Trustee. 

General Provisions I2li 

Advisory Loan Committee. 

General. 

Priority of Applications. 

Maximum Loan. 

Length and Maturity of Loans. 

Interest Rate. 

Repayment of the Loan. 

Security for the Loan. 

Disbursement of Loan Proceeds. 

Regulations and Code. 

Events of Default. 

Remedies. 

Applications, Procedures and 

Approvals. 

Maintenance of Records. 

Audit. 

Insurance. 

Health Facility Construction 

Loan Insurance 1214 



Page 



• 



e L 


Definitions 


§91401. 


Advisory Loan Committee. 


§ 91403. 


Affirmative Action. 


§ 91405. 


Applicant. 


§91407. 


Bondholder 


§ 91409. 


Borrower 


§91411. 


California Health Facilities 




Construction Loan Insurance 




Program — State Plan. 


§91413. 


Contract of Insurance. 


§91415. 


Construction. 


§91417. 


Council. 


§91419. 


Days. 


§91421. 


Debenture. 


§ 91423. 


Office. 


§ 91425. 


Director. 


§ 91427. 


Fund. 


§ 91429. 


Health Facility. 


§91431. 


Health Facility Construction Loan 




Insurance Law. 


§ 91433. 


Lender 


§ 91435. 


Loan. 


§ 91437. 


Loan Insurance. 



§91439. 


Maturity Date. 




§91441. 


Federal Prograin Definitions. 




§ 91443. 


Mortgage. 




§ 91445. 


Mortgagee. 




§91447. 


Mortgagor 




§91449. 


Nonprofit Corporation. 




§91451. 


Political Subdivision. 




§ 91453. 


Project. 




§91455. 


Project Property. 




§91457. 


Public Health Facility. 




§ 91459. 


Statewide Health Facilities and 
Services Plan. 




§91461. 


Title. 




Article 2. 


General Provisions 


. 1216 


§91462. 


Prohibition Against Transactions 
with a Conflict of Interest. 




§91463. 


Types of Loans Eligible for 
Insurance. 




§ 91465. 


Security for Loans. 




§91467. 


Determination of Need for Project. 




§91469. 


Applications, Procedures and 
Approvals. 




§91471. 


Disbursement of Loan Proceeds. 




§91473. 


Certification and Inspection Fees. 




§ 91475. 


Application Fee. 




§91477. 


Insurance Premiums. 




§ 91479. 


Opinion of Legal Counsel. 




§91481. 


Closing of the Loan. 




§91483. 


Bidding Procedures. 




§91485. 


Affirmative Action. 




§91487. 


Maintenance of Records. 




§ 91489. 


Equipment. 




§91491. 


Operation upon Completion of 
Facility. 




§91493. 


Insurance Coverage. 




§ 91495. 


Final Audit. 




§ 91497. 


Financial Statements. 




§ 91499. 


Advisory Loan Insurance 
Committee. 




§ 91550. 


Fee for the Performance of 
Feasibility Studies for Federal Loan 
Insurance Programs. 




Article 3. 


California Health Facilities 
Construction Loan Insurance 






Program — State Plan 


. 1220 


Article 4. 


Defaults 


. 1220 


Article 5. 


Termination of Insurance 


. 1220 


Article 6. 


Health Facility Construction 






Loan Insurance Fund 


. 1220 


Article 7. 


California Health Facilities 
Construction Loan Insurance 






Program — State Plan 


. 1220 


apter 6. 


Health Workforce Pilot Project 






Program 


. 1220 


Article L 


Definitions 


. 1220 


§92001. 


Deputy Director 




§ 92002. 


Clinical Phase. 




§ 92003. 


Didactic Phase. 




§ 92004. 


Employment/Unlization Phase. 




§ 92005. 


Employment/Ufilization Site. 




§ 92006. 


Instructor 




§ 92007. 


Program. 




§ 92008. 


Program Staff. 




§ 92009. 


Project. 




§92010. 


Project Director 




§92011. 


Sponsor 




§ 92012. 


Training Program. 




§92013. 


Training Program. 




Article 2. 


Minimum Standards 


. 1221 



Page iii 



(]- 18-2008) 



Table of Contents 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



Page 



§92101. 


Minimum Standards. 




§ 94045. 


Article 3. 


Application Procedure 


. 1221 


§ 94047. 


§92201. 


Application Forms. 




§ 92202. 


Application Instructions. 






Article 4. 


Content of Application 


1222 


§ 94049. 


§92301. 


Abstract. 




§ 9405 1 . 


§ 92302. 


Purpose and Objectives. 






§ 92303. 


Background Information. 




§ 94053. 


§ 92304. 


Sponsor Information. 




§ 94055. 


§ 92305. 


Participant Selection Information. 






§ 92306. 


Curriculum. 






§ 92307. 


Evaluation. 




Article 4. 


§ 92308. 


Monitoring. 




§ 94056. 


§ 92309. 


Informed Consent. 






§92310. 


Costs. 




Article 5. 


§92311. 


Trainee Information. 




§ 94057. 


§92312. 


Modifications. 




§ 94059. 


§92313. 


Legal Liability. 




§ 94060. 


Article 5. 


Application Review Process 


. 1224 


§94061. 


§92401. 


Review Process for New 




§ 94063. 




Applications. 




§ 94065. 


§ 92402. 


Review for State Agency 
Application. 




§ 94067. 


Article 6. 


Project Approval 


. 1224 


§ 94069. 
§94071. 


§92501. 


Initial Approval. 




§ 94073. 


Article 7. 


Program Responsibilities 


. 1224 


§ 94075. 


§92601. 


Records. 




§ 94077. 


§ 92602. 


Project Evaluation. 






§ 92603. 


Site Visits. 




Article 6. 


§ 92604. 


Continuing Approval. 






Article 8. 


Project Completion/ 




§94081. 
§ 94083. 
§ 94085. 




Termination 


. 1225 


§92701. 


Completion of Project. 




§ 94087. 


§ 92702. 


Termination of Project. 




§ 94089. 
§94091. 


apter 7. 


Seismic Structural Safety 




§ 94093. 




Standards 


. 1226 


Article 7. 


Article 1. 


General Provisions 


. 1226 




§94001. 


Purpose. 




§ 94100. 


§ 94003. 


Scope. 




Article 8. 


§ 94005. 


Authority. 






§ 94007. 


Interpretation. 






§ 94009. 


Application of Regulations. 




§ 94106. 


Article 2. 


Definitions 


. 1226 


Article 9. 


§94011. 


Approved Drawings and 








Specifications. 




§94110. 


§ 94013. 


Building. 






§ 94015. 


Building Safety Board. 




Article 10. 


§94017. 


Contract Documents. 






§ 94019. 


Construction, Reconstruction, 








Alteration and Additions. 




§ 94114. 


§ 94020. 


Deferred Approvals. 




Article 11. 


§94021. 


Department. 






§ 94023. 


Earthquake. 






§ 94025. 


License. 




§94118. 


§ 94027. 


Professionals Approved As Design 
Principals. 




Article 12. 


§ 94029. 


Lateral Force Resisting Capacity. 






§ 94031. 


Structural Elements. 




§ 94122. 


§ 94033. 


Structural Repairs. 




Article 13. 


Article 3. 


Approval of Drawings and 








Specifications 


1226.1 




§ 94037. 


Application for Approval of 








Drawings and Specifications. 




§ 94126. 


§ 94039. 


Preparation of Drawings and 
Specifications. 




Article 14. 


§ 94041. 


Site Data. 






§ 94043. 


Acceptance of Site Data. 




§ 94130. 



Page 

Preliminary Drawings and Outline 

Specifications. 

Acceptance of Preliminai^ 

Drawings and Outline 

Specifications. 

Contract Drawings and 

Specifications. 

Approval of Contract Drawings and 

Specifications. 

Time Limitations for Approval. 

Incremental Design, Bidding and 

Construction. 

Fees 1226.2 

Fees. 

Approval of Construction 1226.2 

Time of Beginning Construction. 

Notice of Start of Construction. 

Notice of Suspension of 

Construction. 

Administration of Constiuction. 

Responsibility of the Contractor 

Confinuous Inspection of the Work. 

Observation by the Department and 

the Department of General Services. 

Tests. 

Verified Reports. 

Addenda, Change Orders, and 

Deferred Approvals. 

Final Approval of the Work. 

Records. 

Appeals Procedures of the 

Building Safety Board 1227 

Appeals. 

Informal Conference. 

Formal Hearing Request. 

Public Hearing on Appeal. 

Rights of the Appellant. 

Appeal Hearing Procedure. 

Decision on Appeal. 

General Design Requirements 

(Testing and Inspection) 1227 

Nonbuilding Regulations. 

Masonry (Testing and 

Inspection) 1227 

Nonbuilding Regulations. 

Wood (Testing and 

Inspection) 1227 

Nonbuilding Regulations. 

Concrete (Testing and 

Inspection) 1227 

Nonbuilding Regulations. 

Steel and L'on (Testing and 

Inspection) 1228 

Nonbuilding Regulations. 

Aluminum (Testing and 

Inspection) 1228 

Nonbuilding Reguladons. 

Excavations, Foundations and 
Retaining Walls (Testing 

and Inspections) 1228 

Nonbuilding Regulations. 

Veneer (Testing and 

Inspection) 1228 

Nonbuilding Regulations. 



Page iv 



(1-18-20 



Title 22 



Health Planning and Facility Construction 



Table of Contents 



Page 



Article 15. 


Masonry or Concrete 
Chimneys, Fireplaces and 
Barbecues (Testing and 






Inspection) 


. 1228 


§94134. 


Nonbuilding Regulations. 




Article 16. 


Contracts 


. 1228 


§ 94602. 


Qualification Criteria. 




apter 8. 


Clinic Renovation (Construction) 






Grant and Loan Program 


. 1228 


Article 1. 


Definitions 


. 1228 


§ 95000. 


Advisory Health Council. 




§ 95005. 


Advisory Loan Committee. 




§95010. 


Director. 




§ 95015. 


Secretary. 




§ 95020. 


Office. 




§ 95025. 


Facility. 




§ 95030. 


Clinic. 




§ 95040. 


Construction Costs. 




§ 95045. 


Renovation. 




§ 95050. 


Fixed Capital Equipment. 




§ 95055. 


Underserved Areas. 




§ 95060. 


Project Property. 




§ 95065. 


Loan. 




§ 95070. 


Borrower. 




§ 95075. 


Mortgage. 




§ 95080. 


Trustee. 




Article 2. 


Eligibility 


. 1229 


§ 95090. 


Applicants. 




Article 3. 


Types of Assistance 


. 1229 


§ 95095. 


Types of Assistance. 




§95100. 


Advisory Loan Committee. 




§ 95120. 


Awards Procedure for Grants and 
Loans. 




Article 4. 


General Provisions 


. 1229 


§ 95130. 


General. 




§ 95135. 


Grant and Loan Purposes. 




Article 5. 


Application for Funds 


. 1229 


§ 95140. 


Procedures. 




§95145. 


Needs. 




§95150. 


Coordination. 




Article 6. 


Selection Process 


. 1229 


§95155. 


Notice and Pre-Application. 




§ 95160. 


Financial Assistance Application. 




§ 95165. 


Method of Selection of Applicants 
for Awards. 




§ 95170. 


Encumberment. 




Article 7. 


Administration 


. 1230 


§ 95175. 


General. 




§ 95180. 


Priority of Applications. 




§95185. 


Second Grant Cycle. 




§ 95200. 


Maximum Grant. 




§ 95210. 


Loans. 




§ 95220. 


Repayment of the Loan. 




§ 95230. 


Security for the Loan. 




§ 95240. 


Disbursement of Loan Proceeds or 
Grant Awards. 




§ 95250. 


Events of Default. 




§ 95260. 


Remedies. 





§96010. 

§ 96015. 

§ 96020. 
§ 96025. 



Article 2. 



Chapter 9. 



Article 1. 



§ 96000. 
§ 96005. 



Hospital Charges and Fair 
Pricing Policies Reporting ... 

Hospital Charge Description 
Master Reporting 

Definitions. 

Charge Description Master 

Reporting. 



1230 



1230 



§ 96040. 
§ 96041 . 

§ 96042. 



§ 96043. 
§ 96044. 
§ 96045. 

§ 96046. 
§ 96050. 



Chapter 10. 

Article 1. 

§ 97003. 
§ 97005. 
§ 97007. 



§ 97008. 

Article 2. 

§97015. 
§ 97016. 
§ 97017. 

§ 97018. 

§ 97019. 

§ 97020. 
§ 97030. 

Article 3. 

§ 97040. 
§97041. 
§ 97042. 
§ 97043. 
§ 97044. 
§ 97045. 

Article 4. 

§ 97050. 

§97051. 

§ 97052. 
§ 97053. 
§ 97054. 



Page 

List of Common Outpatient 

Procedures Reporting. 

Estimate of Revenue Increase 

Reporting. 

Methods of Submission. 

Request for Modifications to 

Requirements. 

Hospital Fair Pricing 

Policies Reporting 1231 

Definitions. 

Hospital Discount Payment and 

Charity Care Policies Reporting. 

Electronic Reporting of Hospital 

Discount Payment and Charity Care 

Policies, Eligibility Procedures, and 

Review Process. 

Electronic Reporting of Hospital 

Application Form for Charity Care 

or Discount Payment Programs. 

Reporting Significant Changes to 

Hospital Discount Payment and 

Charity Care Policies. 

Reporting Significant Changes to 

Hospital Charity Care or Discount 

Payment Programs Application 

Forms. 

Method of Submission of Fair 

Pricing Documents and 

Notifications. 

Request for Modifications to 

Requirements. 

Health Facility Data 1232 

General 1232 

Accounting System Requirements. 

Definitions. 

Notice of Change in Health Facility 

Fiscal Year, Licensure, Name, 

Address, or Closure. 

Notice of New Health Facility 

Operations. 

Accounting System 

Requirements 1233 

Chart of Accounts. 

Accrual Accounting. 

Special Accounting Requirements 

and Account Codes. 

Accounting and Reporting Manual 

for California Hospitals. 

Accounting and Reporting Manual 

for California Long-Term Care 

Facilities. 

Delayed Implementation of LTC 

Accounting Manual Second Edition. 

Failure to Meet Accounting 

Requirements. 

Reporting Requirements 1235 

Required Annual Reports. 
Report Procedure. 
Comparative Reports. 
Form of Authentication. 
Exceptions to Required Reports. 
Failure to File Required Reports. 

Modification, Extension, and 

Appeal Processes 1236 

Request for Modificafions to 

Approved Accounting and 

Reporting Systems. 

Requests for Extension Time to File 

Required Reports. 

Appeal Procedure. 

Conduct of Hearing. 

Decision on Appeal. 



Page 



(1-18-2008) 



Table of Contents 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



Article 5. 


§ 97062. 


§ 97063. 


§ 97064. 


§ 97065. 


Article 6. 


§97110. 


§97115. 


§ 97125. 


Article 7. 


§97170. 


§97172. 


§97174. 


§ 97176. 


§97178. 


§ 97180. 


§97182. 


§ 97184. 


§ 97186. 


§97188 


§ 97190 


§97192 


§97194 


§ 97196 


§ 97198 


Article 8. 



Page 



1236.2 



Page 



§ 97210. 

§97211. 
§97212. 
§ 97213. 
§ 97214. 
§97215. 
§97216. 

§97217. 

§ 97218. 

§97219. 

§ 97220. 

§ 97221. 
§ 97222. 
§ 97223. 
§ 97224. 
§ 97225. 

§ 97226. 

§ 97227. 
§ 97228. 



Collection of Special Fees . 
Notice of Assessment. 
Basis of Assessment. 
Exceptions to the Basis of 
Assessment. 
Delinquent Special Fees. 



Public Availability of 

Disclosure Materials 1237 

Place and Time of Availability. 

Manner of Requesting Disclosure 

Materials. 

Protection of Records. 

CABG Data Reporting 

Requirements 1237 

Definitions, as Used in this Article. 

Required Reporting. 

Required Data Elements. 

Reporting Periods and Due Date. 

Extensions to File Report. 

Method of Data Collection. 

Report Format. 

Report Acceptance Criteria. 

Report Acceptance or Rejection. 

Surgeon Certification of Data. 

Hospital Certification of Data. 

Correction of Data. 

Audit Procedure. 

Hospital Data Contact Person. 

Failure to File a CABG Report. 

Patient Data Reporting 

Requirements 1238.7 

Contact Person, User Account 

Administrator, Designated Agent, 

and Facility Identification Number. 

Reporting Periods and Due Dates. 

Definitions, as Used in This Article. 

Required Reporting. 

Form of Authentication. 

Format. 

Definition of Data Element for 

Inpatients — Date of Birth. 

Definition of Data Element for 

Inpatients — Sex. 

Definition of Data Element for 

Inpatients — Race. 

Definition of Data Element for 

Inpatients — ZIP Code. 

Definition of Data Element for 

Inpatients — Patient Social Security 

Number. 

Definition of Data Element for 

Inpafients — Admission Date. 

Definition of Data Element for 

Inpatients — Source of Admission. 

Definition of Data Element for 

Inpafients — Type of Admission. 

Definifion of Data Element for 

Inpatients — Discharge Date. 

Definition of Data Element for 

Inpatients — Principal Diagnosis and 

Whether the Condifion was Present 

at Admission. 

Definifion of Data Element for 

Inpatients — Other Diagnoses and 

Whether the Conditions were 

Present at Admission. 

Definition of Data Element for 

Inpatients — External Cause of 

Injury. 

Definition of Data Element for 

Inpafients — Principal Procedure and 

Date. 



Page 



VI 



§ 97229. 


Definition of Data Element for 




Inpatients — Other Procedures and 




Dates. 


§ 97230. 


Definition of Data Element for 




Inpatients — Total Charges. 


§97231. 


Definition of Data Element for 




Inpatients — Disposifion of Pafient. 


§ 97232. 


Definifion of Data Element for 




Inpatients — Expected Source of 




Payment. 


§ 97233. 


Definition of Data Element for 




Inpatients — Prehospital Care and 




Resuscitation. 


§ 97239. 


Hospital Idenfificafion Number. 


§ 97240. 


Request for Modificadons to Patient 




Data Reporting. 


§97241. 


Extensions of Time to File Reports. 


§ 97242. 


Error Tolerance Levels. 


§ 97243. 


Acceptance Criteria. 


§ 97244. 


Method of Submission. 


§ 97245. 


Online Test Opfion. 


§ 97246. 


Data Transmittal Requirements. 


§ 97247. 


Approval Criteria. 


§ 97248. 


Error Tolerance Level. 


§ 97249. 


Hours of Operanon. 


§ 97250. 


Failure to File a Data Report. 


§97251. 


Definifion of Data Element for ED 




and AS— Date of Birth. 


§ 97252. 


Definition of Data Element for ED 




and AS — Sex. 


§ 97253. 


Definition of Data Element for ED 




and AS — Race. 


§ 97254. 


Definition of Data Element for ED 




and AS — Ethnicity. 


§ 97255. 


Definifion of Data Element for ED 




and AS— ZIP Code. 


§ 97256. 


Definition of Data Element for ED 




and AS — Patient Social Security 




Number. 


§ 97257. 


Definition of Data Element for ED 




and AS — Service Date. 


§ 97258. 


Definition of Data Element for ED 




and AS — Principal Diagnosis. 


§ 97259. 


Definition of Data Element for ED 




and AS — Other Diagnoses. 


§ 97260. 


Definition of Data Element for ED 




and AS — Principal External Cause 




of Injury. 


§ 97261. 


Definition of Data Element for ED 




and AS — Other External Cause of 




Injury. 


§ 97262. 


Definition of Data Element for ED 




and AS — Principal Procedure. 


§ 97263. 


Definifion of Data Element for ED 




and AS — Other Procedures. 


§ 97264. 


Definifion of Data Element for ED 




and AS — Disposifion of Patient. 


§ 97265. 


Definition of Data Element for ED 




and AS — Expected Source of 




Payment. 


§ 97266. 


Freestanding Ambulatory Surgery 




Encounter Fee Assessment. 


hapter 1 1 . Alzheimer's Disease Institute 


Demonstration Project 1251 


Subchapter 1. 


Definitions 1251 


§97300.1. 


Accredited Record Technician. 


§ 97300.3. 


Acfivity Leader. 


§ 97300.5. 


Administrator. 


§ 97300.7. 


Advertisement. 


§ 97300.9. 


All Settings. 


§97300.11. 


Alzheimer's Disease Institute. 


§ 97300.13. 


Alzheimer's Disease. 


§ 97300.15. 


Ambulatory Patient. 


§ 97300.17. 


Arranged For. 


§ 97300.19. 


Art Therapist. 


§ 97300.21. 


Attending Physician. 




(1-18-2008) 



Title 22 



Health Planning and Facility Construction 



Table of Contents 



Page 



Page 



§ 97300.23. Audiologist. 

§ 97300.25. Autoclaving. 

§ 97300.27. Authorized Representative. 

i? 97300.29. Biological. 

§97300.31. Caiegivers. 

§ 97300.33. Case Manager. 

§ 97300.35. Case Management. 

§ 97300.37. Cleaning. 

§ 97300.39. Comprehensive Assessment. 

§97300.41. Conservator. 

§ 97300.43. Consultant. 

§ 97300.45. Continuum of Care. 

§ 97300.47. Controlled Drugs. 

§ 97300.49. Coordinated Clinical Interventions. 

§ 97300.5 1 . Dance Therapist. 

§ 97300.53. Dangerous Drug. 

§ 97300.55. Decubitus Ulcer. 

§ 97300.57. Deficiency. 

§ 97300.59. Defined. 

§97300.61. Dementia. 

§ 97300.63. Dentist. 

§ 97300.65. Department. 

§ 97300.67. Designation Certificate. 

§ 97300.69. Designee. 

§ 97300.71. Diagnostic Evaluation. 

§ 97300.73. Dietetic Service— General. 

§ 97300.75. Dietetic Service Supervisor. 

§ 97300.77. Dieutian. 

§ 97300.79. Differential Diagnosis. 

§97300.81. Director. 

§ 97300.83. Disinfection. 

§ 97300.85. Distinct Part. 

§ 97300.87. Drug. 

§ 97300.89. Drug Administration. 

§ 97300.9 1 . Drug Dispensing. 

§ 97300.93. Evaluation. 

§ 97300.95. Fomites. 

§ 97300.97. Full-Time Equivalent. 

§ 97300.99. Governing Body. 

§ 97300.103. Infectious Wastes. 

§97300.105. Inpatient. 

§97300.107. Inspection Visit. 

§97300.109. Institute. 

§ 97300. 111. Intake Management. 

§97300.113. Integrated. 

§ 97300.115. Interdisciplinary Team. 

§ 97300.117. Intermediate Care Bed 

Classification. 

§ 97300. 119. Licensed Nurse. 

§ 97300.121. Licensed Vocational Nurse. 

§97300.123. Local Bank. 

§97300.125. Maintenance. 

§ 97300.127. Meaning of Words. 

§ 97300. 1 29. Mechanically Altered Diet. 

§97300.131. Medication. 

§97300.133. Music Therapist. 

§ 97300.135. Narrafive Notes. 

§97300.137. New Construction. 

§97300.139. Nonambulatory Patient. 

§97300.141. Nursing Unit. 

§ 97300.143. Occupational Therapist. 

§ 97300.145. Occupational Therapy Aide. 

§ 97300.147. Occupational Therapy Assistant. 

§97300.149. Office. 

§97300.151. Patient. 

§97300.153. Patient File. 

§ 97300.155. Permanently Converted. 

§97300.157. Pharmacist. 

§ 97300. 1 59 . Physical Therapist. 

§ 97300.161. Physical Therapist Aide. 

§ 97300. 163. Physical Therapist Assistant. 

§ 97300.165. Physician. 

§ 97300.167. Physician's Assistant. 

§97300.169. Plan of Corrections. 

§97300.171. Podiatrist. 

§97300.173. Program Administrator 

§ 97300.175. Protocol. 



§97300.177. Provider 

§97300.179. Psychiatrist. 

§97300.181. Psychologist. 

§97300.183. Public Health Nurse. 

§97300.185. Qualified Applicant. 

§ 97300.187. Recreation Therapist. 

§ 97300. 1 89. Registered Nurse. 

§ 97300.191. Registered Record Administrator 

§97300.193. Registry' Staff 

§ 97300. 195. Related Dementias. 

§ 97300.197. Research. 

§97300.199. Restraint. 

§ 97300.203. Services Unit. 

§ 97300.205. Services Unit Patient Health 

Record. 

§ 97300.207. Skilled Nursing Care Bed 

Classification. 

§ 97300.209. Social Work Aide. 

§ 97300.2 1 1 . Social Work Assistant. 

§97300.213. Social Worker 

§ 97300.215. Speech Pathologist. 

§ 97300.217. Speech Therapist. 

§ 97300.219. Standing Orders. 

§97300.221. Sterilization. 

§ 97300.223. Supervision. 

§ 97300.225. Therapeutic Diet. 

§ 97300.227. Treatment and Management Plan. 

§ 97300.229. Type of Services. 

§ 97300.23 1 . Unit Dose Medication System. 

Subchapter 2 



General Requirements 1263 

Article 1. Institute Administration 1263 

Administrator 

Designee — General Duties. 

Designation. 

Advertising. 

Data. 

Equipment and Supplies. 

Consumer Information to Be 

Posted. 

Required Committees. 

Patient Care Policies and 

Procedures. 

Administrative Policies and 

Procedures. 

Arranged for Services. 

Bonds. 

Reports and Monitoring. 

Agreement with School of 

Medicine. 

Research and Evaluation. 

Family Services. 

Patient Services Management 1267 



§97320.1. 
§ 97320.3. 
§ 97320.5. 
§ 97320.7. 
§ 97320.9. 
§97320.11. 
§97320.13. 

§97320.15. 
§97320.17. 

§ 97320.19. 

§ 97320.21. 
§ 97320.23. 
§ 97320.25. 
§ 97320.27. 

§ 97320.29. 
§ 97320.31. 

Article 2. 

§97321.1. 
§97321.3. 
§97321.5. 
§97321.7. 
§97321.11. 

§97321.13. 
§97321.15. 
§97321.17. 
§97321.19. 
§97321.21. 
§97321.23. 
§ 97321.25. 
§ 97321.27. 
§97321.29. 
§97321.31. 

§97321.33. 
§97321.35. 
§97321.37. 

§97321.39. 
§ 97321.41. 



Services Provided. 

Admission of Patients. 

Intake Management. 

Admissions. 

Clinical Diagnosis of Alzheimer's 

Disease. 

Comprehensive Assessment. 

Treatment and Management Plan. 

Needs of Patients. 

Admission Records. 

Patient Identification. 

Patients' Health Records. 

Content of Health Records. 

Patients' Care Plan. 

Patients' Rights. 

Safeguards for Patients' Monies and 

Valuables. 

Patient Transfer 

Bed or Services Unit Space Hold. 

Liability for Rent and Return of 

Rental Advance. 

Patient Death Reports. 

Central Patient File. 



Page vii 



(1-18-2008) 



Table of Contents 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



Page 



Page 



§ 97321.43. Dietetic Service — Food Service. 

§ 9732 1 .45. Dietetic Service — Diet Manual. 

§ 97321 .47. Dietetic Service — Policies and 

Procedures. 
Jj 9732 1 .49. Dietetic Service — Therapeutic 

Diets. 
§ 97321.51. Dietetic Service — Menus. 

§ 97321.53. Dietetic Service — Food Storage. 

§ 9732 1 .55. Dietetic Service — Sanitation. 

§ 97321 .57. Dietetic Service — Cleaning and 

Disinfection of Utensils. 
§ 97321 .59. Dietetic Service — Equipment and 

Supplies. 
i^ 9732 1.61. Dietetic Service-Staff. 

§97321.63. Dietetic Service — In-Service 

Training. 
§97321.65. Pharmaceutical Service-General. 

§97321.67. Pharmaceutical Service-Policies 

and Procedures. 
§97321.69. Pharmaceutical 

Service-Requirements. 
§ 97321.71. Pharmaceutical Service-Labeling 

and Storage of Drugs. 
§97321.73. Pharmaceutical Service — Standing 

Orders. 
§ 97321.75. Pharmaceutical Service — Stop 

Orders. 
§ 97321.77. Pharmaceutical Service — Orders for 

Drugs. 
§97321.79. Pharmaceutical Service — Drug 

Order Processing. 
§ 9732 1.81. Pharmaceutical Service — Drug 

Order Records. 
§97321.83. Pharmaceutical Service — Personal 

Medications. 
§ 97321.85. Pharmaceutical Service— Controlled 

Drugs. 
§97321.87. Pharmaceutical 

Service — Disposition of Drugs. 
§ 97321 .89. Pharmaceutical Service— Unit Dose 

Medication System. 
§ 97321.91. Pharmaceutical Service— Staff. 

§97321.93. Pharmaceutical 

Service — Equipment and Supplies. 
§ 97321.95. Activity Program — Requirements. 

§ 97321 .97. Activity Program — Activity Plan. 

§ 97321 .98. Activity Program— Staff. 

§ 97321.99. Activity Program — ^Equipment and 

Supplies. 
§ 97321.101. Activity Program— Space. 

§ 97321 .103. Activity Program — Policies and 

Procedures. 
§ 97321.105. Additional Programs — General. 

§97321.107. Physical Therapy 

Program — Services . 
§ 97321 .109. Physical Therapy 

Program — Policies and Procedures. 
§ 9732 1 . 1 1 1 . Physical Therapy Program— Staff . 

§97321.113. Physical Therapy 

Program — Equipment. 
§ 97321 .115. Physical Therapy Program— Space. 

§ 97321.117. Occupational Therapy 

Program — Services. 
§97321.119. Occupational Therapy 

Program — Pohcies and Procedures. 
§97321.121. Occupational Therapy 

Program — Staff. 
§97321.123. Occupational Therapy 

Program — Equipment. 
§97321.125. Occupational Therapy 

Program — Space. 
§ 9732 1 . 1 27. Speech Pathology and/or Audiology 

Program — Services. 
§ 9732 1 . 1 29. Speech Pathology and/or Audiology 

Program — Policies and Procedures. 
§ 97321.131. Speech Pathology and/or Audiology 

Program — Staff. 



§ 97321 .133. Speech Pathology and/or Audiology 

Program — Equipment. 
§ 97321.135. Speech Pathology and/or Audiology 

Program — Space. 
§ 97321.137. Social Work Program — Services. 

§ 97321 .139. Social Work Program — Policies and 

Procedures. 
§97321.141. Social Work Program— Staff . 

§ 97321.143. Social Work Service 

Program — Equipment and Supplies. 
§ 97321 .145. Social Work Program— Space. 

§ 97321.147. Psychiatric or Psychological 

Services Program. 
§ 97321.149. Transportation Services Program. 



Article 3. 



Staff 



1283 



§97322.1. Administrator. 

§ 97322.3. Institute Staff. 

§ 97322.5. Case Management. 

§97322.7. Staff Development. 

§ 97322.9. Nurse Assistant Training and 

Certification. 
§ 97322.1 1 . Employee Personnel Records. 

§ 97322.13. Employees' Health Examination 

and Health Records. 
§97322.15. Governance. 

Article 4. Environmental Safety and 

Health 1288 

Multiple Buildings. 

Fire Safety. 

Fire and Internal Disasters. 

Smoking. 

Externa] Disaster and Mass Casualty 

Program. 

Reporting of Conrununi cable 

Diseases. 

Reporting of Outbreaks. 

Unusual Occurrences. 



§97323.1. 
§ 97323.3. 
§ 97323.5. 
§ 97323.7. 
§ 97323.9. 

§97323.11. 

§97323.13. 
§97323.15. 

Article 5. 

§97324.1. 
§ 97324.3. 
§ 97324.5. 
§ 97324.7. 
§ 97324.9. 
§97324.11. 
§97324.13. 
§97324.15. 
§ 97324.17. 

§97324.19. 
§97324.21. 
§ 97324.23. 



§ 97324.25. 
§ 97324.27. 
§ 97324.29. 
§97324.31. 
§ 97324.33. 
§ 97324.35. 
§ 97324.37. 
§ 97324.39. 
§97324.41. 
§ 97324.43. 
§ 97324.45. 

§ 97324.47. 

§ 97324.49. 
§97324.51. 
§ 97324.53. 
§ 97324.55. 
§ 97324.57. 
§ 97324.59, 
§97324.61. 



Physical Plant 

Distinct Part. 

Multiple Buildings. 

Application for Plan Review. 

Space Conversion. 

Notice to Office. 

Patient Capacity. 

Patient Rooms. 

Special Rooms. 

Patient's Property Storage and 

Room Furnishings. 

Provision for Privacy. 

Public Telephone. 

Space and Equipment for 

Autoclaving, Sterilizing and 

Disinfecting. 

Housekeeping. 

Laundry. 

Clean Linen. 

Soiled Linen. 

Provisions for Emptying Bedpans. 

Signal Systems. 

Utility Rooms. 

Handrails. 

General Maintenance. 

Air Filters. 

Emergency Lighting and Power 

System. 

Storage and Disposal of Solid 

Wastes. 

Solid Waste Containers. 

Infectious Waste. 

Gases for Medical Use. 

Water Supply and Plumbing. 

Lighting. 

Maintenance Manual. 

Mechanical Systems. 



1289 



Page viii 



(1-18-20 



Title 22 



Health Planning and Facility Construction 



Table of Contents 



Page 

S 97324.63. Screens. 

§ 97324.65. Storage. 

S 97324.67. Construction "Variances. 

§ 97324.69. Recreation and Dining Areas. 

§ 97324.71 . Nursing Stations. 

§ 97324.73. Disinfecting and Sterilizing. 

§ 97324.75. Maintenance and Operation. 

§ 97324.77. Cleaning Equipment and Fixtures. 

Article 6. Standards for All Types of 

Services 1295 

Program Flexibility. 
Other Departments. 
Advisory Committee. 
Patient Population. 
Conflict Between Regulations 
Affecting Types of Inpatient 
Services. 

Monitoring and Compliance 1295 

Access to Records and Facility 

Sites. 

Inspection of Institutes and/or Other 

Providers of Care. 

Consultation. 

Notice of Deficiencies. 

Follow-up Visit. 

Reasons for 

SuspendingAVithdrawing 

Demonstration Project Designation. 

Methods of Withdrawing or 

Suspending Demonstration Project 

Designation. 

Hearing Procedure. 

Subchapter 3. Skilled Nursing Services 1297 

Article 1 . Definitions 1297 

§97331.1. 
§97331.3. 
§97331.5. 
§97331.7. 



§97325.1. 
§ 97325.3. 
§ 97325.5. 
§ 97325.7. 
§ 97325.9. 



Article 7. 

§97326.1. 

§ 97326.3. 

§ 97326.5. 
§ 97326.7. 
§ 97326.9. 
§97326.11 



§97326.13 



§97326.15 



Article 2. 

§97332.1. 

Article 3. 

§97333.1. 
§ 97333.3. 
§ 97333.5. 

§ 97333.7. 
§ 97333.9. 

§97333.11. 
§97333.13. 
§97333.15. 

§97333.17. 

§97333.19. 

§97333.21. 
§ 97333.23. 



Definitions 

Administrator. 

Director. 

Nursing Service. 

Skilled Nursing Services Unit. 

Designation 

Designation. 



1297 



Required Services 1297 

Required Services. 
Nonphysician Practitioners. 
Physician Services — Supervision of 
Care. 

Nursing Service — General. 
Nursing Service — Administration of 
Medications and Treatments. 
Nursing Service — Patient Care. 
Nursing Service — Standing Orders. 
Nursing Service — Restraints and 
Postural Supports. 
Nursing Service — Patients with 
Infectious Diseases. 
Nursing Service — Cleaning, 
Disinfecting and Sterilizing. 
Nursing Service — Space. 
Nursing Service — Staff. 

Article 4. Administration 130I 

§97335.1. Designee — General Duties. 

§ 97335.3. Program Administrator. 

Subchapter 4. Intermediate Care 

Services 1301 

Article 1 . Definitions 1301 

§97341.1. Administrator. 

§97341.3. Director. 

§ 97341 .5. Intermediate Care Services Unit. 

§ 97341 .7. Nursing Service. 

Article 2. Designation 1301 



Page 

§97342.1. Designation. 

Article 3. Services 1302 

§97324.1. Required Services. 

§ 97343.3. Nursing Service — General. 

§ 97343.5. Nursing Service — Drug 

Administration. 
§ 97343.7. Nursing Service — Patient Care. 

§ 97343.9. Nursing Service — Policies and 

Procedures. 
§ 97343. 1 1 . Nursing Service— Staff. 

§ 97343.13. Nursing Service — Equipment and 

Supplies. 

Article 4. Administration 1303 

§ 97345.1. Designee — General Duties. 

§ 97345.3. Program Administrator. 

Subchapter 5. Outpatient Care 

Definitions 1303 

Article 1. Definitions 1303 

§97350.1. Administrator. 

§ 97350.3. Dental Clinic. 

§ 97350.5. Outpatient Care. 

§ 97350.7. Outpatient Care Services Unit. 

§ 97350.9. Podiatric Clinic. 

Article 2. Designation 1304 

Article 3. Basic Services 1304 

§ 97352.1. Basic Services— General 

Requirements. 
§ 97352.3. Basic Services— Medical Staff. 

§ 97352.5. Basic Services — Nursing Staff. 

§ 97352.7. Basic Services— Other Health 

Personnel. 
§ 97352.9. Basic Services — Policies and 

Procedures. 
§ 97352.11. Basic Services — Equipment and 

Supplies. 

Article 4. Drug Distribution 1305 

§ 97353.1. Drug Distribution Service — General 

Requirements. 
§ 97353.3. Drug Distribution Service — Policies 

and Procedures. 
§ 97353.5. Drug Distribution Service — Orders 

for Drugs. 
§ 97353.7. Drug Distribution 

Service — Administration of Drugs. 
§ 97353.9. Drug Distribution 

Service — Dispensing of Drugs. 
§ 97353.11. Drug Distribution Service — Storage 

of Drugs. 
§ 97353.13. Drug Distribution Service— Staff. 

§ 97353.15. Drug Distribution 

Service — Equipment and Supplies. 

Article 5. Administration 1306 

§97354.1. Administrator. 

§ 97354.3. Posting of Outpatient Care Services 

Unit Schedule. 
§ 97354.5. Quality Assurance Evaluation 

Program. 

Subchapter 6. Day Health Care Services 1306 

Article 1 . Definitions 1306 

§97361.1. Administrator. 

§ 97361 .3. Day Health Care Services Unit. 

§97361.5. Director. 

Article 2. Designation 1307 

§97362.1. Designation. 

Article 3. Services 1307 

§ 97363.1 . Basic Program Services — General. 

§ 97363.3. Basic Program Services — Nursing 

Services. 
§ 97363.5. Nursing Services — Restraints. 



Page ix 



(1-18-2008) 



Table of Contents 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



Page 

§ 97363.7. Nursing Services — Medications. 

§ 97363.9. Basic Services — Recreation or 

Planned Social Activities. 
§97363.11. Optional Services. 

Article 4. Administration 1309 

§97364.1. Plan of Operation. 

§ 97364.3. Employee Requirements. 

§ 97364.5. Administrator. 

$ 97364.7. Program Director. 

§ 97364.9. Staffing Requirements. 

Article 5. Physical Plant 1311 

§ 97365.1 . Space Requirements. 

$ 97365.3. . Supplies. 

Subchapter 7. Social Day Care Services 1311 

Article 1. Definitions 1311 

§97370.1. Administrator. 

§ 97370.3. Functional Impairment. 

§ 97370.5. Psychosocial Support Services. 

§ 97370.7. Social Day Care Services Unit. 

Article 2. Administration 1311 

§ 97372. 1 . Plan of Operation. 

§ 97372.3. Hours of Operation. 

§ 97372.5. Program Administrator. 

§ 97372.7. Staffing. 

§ 97372.9. Staff-Patient Ratio. 

Article 3. Patient Services 1312 

§ 97373.1. Essential Services. 

§ 97373.3. Activities. 

§ 97373.5. Schedule. 

§ 97373.7. Program Evaluation. 

Article 4. Designation 1313 

§97374.1. Designation. 

Subchapter 8. Home Health Care 

Services 1313 

Article 1. Definitions 1313 

§97381.1. Administrator. 

§ 97381.3. Director. 

§ 97381.5. Home Health Aide. 

§ 97381 .7. Home Health Care Services. 

§ 97381 .9. Home Health Care Services Unit. 

§ 9738 1 .11. Part-Time or Intermittent Care. 

Article 2. Designation 1313 

§97382.1. Designation. 

Article 3. Services 1314 

§ 97383.1 . Services Provided. 

§ 97383.3. Treatment and Rehabilitative 

Services. 
§ 97383.5. Patient's Care Plan. 

§ 97383.7. Orders for Medication and 

Treatment. 
§ 97383.9. Unit Nursing Supervisor. 

§ 97383. 1 1 . Nursing Services Staff 

§ 97383.13. Nursing Services. 

§ 97383.15. Home Health Aide Services. 

§ 97383.17. Therapy Services. 

§ 97383.19. Diet Counsehng Services. 

Article 4. Administration 1316 

§ 97384. 1 . Administrator. 

§ 97384.3. Written Administrative Policies. 

§ 97384.5. Program Evaluation. 

§ 97384.7. Utilization Review. 

Article 5. Qualifications for Home 

Health Aide Certification 1317 

§ 97385. 1 . Home Health Aide Certification. 

§ 97385.3. Home Health Aide Training. 



Page 

§ 97385.5. Issuance, Denial, Revocation or 

Suspension of Home Health Aide 
Certificate. 

Subchapter 9. In-Home Supportive 

Services 1318 

Article 1. Definition 1318 

§ 97390. 1 . Program Definition. 

§ 97390.3. In-Home Supportive Services Unit. 

Article 2. Designation 1318 

§97391.1. Designation. 

Article 3. Services 1318 

§97392.1. Individual Plan of Care. 

§ 97392.3. Domestic Services. 

§ 97392.5. Related Services. 

§ 97392.7. Non-Medical Personal Services. 

§ 97392.9. Health Care Services. 

§ 97392.1 1. Protective Supervision. 

§ 97392.13. Teaching and Demonstration 

Services. 

Article 4. Staff 1319 

§97394.1. Staff 

Article 5. Administration 1319 

§97395.1. Administrator. 

§ 97395.3. Program Evaluation. 

Subchapter 10. Respite Care Services 1319 

Article 1. Definitions 1319 

§ 9740 1.1. Administrator. 

§97401.3. Respite Care. 

§ 97401.5. Respite Care Services Unit. 

Article 2. Training 1320 

§97402.1. Training. 

Article 3. Administration 1320 

§ 97403. 1 . Administrator. 

§ 97403.3. Staff. 

Article 4. Services 1320 

§ 97404. 1 . Required Services. 

§ 97404.3. Respite Care Plan. 

§97404.5. Type of Care. 

§ 97404.7. Coordination. 

§ 97404.9. Standards for Services Provided. 

Article 5. Designation 1320 

§97405.1. Designation. 

§ 97405.3. Program Evaluation. 

Subchapter 11. Hospice Care Services 1321 

Article 1. Definitions 1321 

§97411.1. Administrator. 

§ 97411.3. Bereavement Counseling. 

§97411.5. Hospice Care. 

§ 9741 1 .7. Hospice Care Services Unit. 

§97411.9. Representative. 

§97411.11. Terminally 111. 

Article 2. Required Services I32I 

§97412.1. Required Services. 

§ 97412.3. Physician Services — Supervision of 

Care. 
§ 97412.5. Nursing Services. 

§ 97412.7. Hospice Home Care Services. 

§ 97412.9. Inpatient Services — Policies and 

Procedures. 

Article 3. Staff 1322 

§ 97413.1. Hospice Treatment Team. 

§ 97413.3. Hospice Treatment Team Services. 

§ 97413.5. Medical Director. 

§ 97413.7. Nursing Services. 

§ 97413.9. Psychological/Social Work 
Services. 



Page X 



(1-18-2008) 



Title 22 



Health Planning and Facility Construction 



Table of Contents 



• 



Page 

§974J3.1]. Volunteers. 

Article 4. Continuity of Care 1323 

§97414.1. Continuity of Care. 

§ 97414.3. Inpatient Services. 

Article 5. Other Services 1324 

§ 9741 6. 1 . Counseling Services. 

§97416.3. Therapy Services. 

§ 97416.5. Home Health Aide. 

§ 97416.7. Supervision. 

§97416.9. Duties. 

§97416.11. Inpatient Care. 

Article 6. Administration 1325 

§97417.1. Administrator. 

Article 7. Designation 1325 

§97418.1. Designation. 

Subchapter 12. Residential Care 

Services 1325 

Article 1 . Definitions 1325 

§97420.1. Administrator. 

§ 97420.3. Residential Care Services. 

§ 97420.5. Residential Care Services Unit. 

Article 2. Designation 1325 

§97421.1. Designation. 

Article 3. Administration and Staffing 

Requirements 1325 

§ 97425 . 1 . Plan of Operation . 

§ 97425.3. Personnel Requirements — General. 

§ 97425.5. Personnel — Operations. 

§ 97425.7. Night Supervision. 

§ 97425.9. Administrator. 

Article 4. Basic Services 1326 

§97426.1. Basic Services. 

§ 97426.3. Personal Accommodations and 

Services. 
§ 97426.5. Personal Assistance and 

Care — Restraints and Postural 

Supports. 
§ 97426.7. Observation of the Patient. 

§ 97426.9, Incidental Medical and Dental Care. 

§97426.11. Planned Activities. 

Subchapter 13. Referral Services 1329 

Article 1 . Definitions 1329 

§ 9743 1.1. Administrator. 

§ 97431.3. Referral Services. 

§ 97431.5. Referral Services Unit. 

Article 2. Designation 1329 

§97432.1. Designation. 

Article 3. Administration 1329 

§ 97433.1. Administrator. 

§ 97433.3. Staff. 

Article 4. Services 1330 

§97434.1. Referral Services. 

§ 97434.3. Referrals. 

§ 97434.5. Minimum Services. 

§ 97434.7. Coordination. 

§ 97434.9. Other Services. 

Chapter 12. Postsurgical Recovery Care 

Demonstration Project 1330 

Article 1 . Definitions 1330 

§ 97500. 1 . Meaning of Words. 

§ 97500.3. Accredited Record Technician. 

§ 97500.5. Administrator. 

§ 97500.7. Alteration. 



Page 



§ 97500.9. Attending Surgeon. 

§97500.11. Autoclaving. 

§ 97500.13. Authorized Representative. 

§97500.15. Biological. 

§97500.17. Cleaning. 

§97500.19. Consultant. 

§ 97500.21 . Controlled Drugs. 

§ 97500.23. Dangerous Drug. 

§ 97500.25. Defined. 

§ 97500.27. Dentist. 

§ 97500.29. Designation Agreement. 

§97500.31. Designee. 

§ 97500.33. Dietetic Service. 

§ 97500.35. Director. 

§ 97500.37. Director of Nursing. 

§ 97500.39. Distinct Part. 

§97500.41. Drug. 

§ 97500.43. Drug Administration. 

§97500.45. Drug Dispensing. 

§ 97500.47. Facility. 

§ 97500.49. Freestanding. 

§ 97500.51 . Full-Time Equivalent. 

§ 97500.53. General Acute Care Hospital. 

§ 97500.55. Governing Body. 

§ 97500.57. Health Facility. 

§ 97500.59. Hospital. 

§ 97500.61 . Infectious Wastes. 

§ 97500.63. Inspection Visit. 

§ 97500.65. Licensed Nurse. 

§ 97500.67. Licensed Vocational Nurse. 

§ 97500.69. Maintenance. 

§ 97500.7 1 . Medical Director. 

§ 97500.73. Medical Emergency. 

§ 97500.75. Medical Staff. 

§ 97500.77. Medication. 

§ 97500.79. New Construction. 

§97500.81. Nurses' Notes. 

§ 97500.83. Nursing Service. 

§ 97500.85. Nursing Unit. 

§ 97500.87. Office. 

§ 97500.89. Outpatient Surgical Procedure. 

§97500.91. Overnight. 

§ 97500.93. Patient. 

§ 97500.95. Patient Chart. 

§ 97500.97. Participation Agreement. 

§ 97500.99. Participating Surgery Program. 

§ 97500.101 . Pediatric Patient. 

§ 97500.103. Pharmacist. 

§ 97500.105. Pharmaceutical Service. 

§97500.107. Physician. 

§ 97500.109. Podiatrist. 

§ 97500. 111. Postsurgical Recovery Care Facility. 

§ 97500.113. Registered Dietitian. 

§ 97500.115. Registered Nurse. 

§ 97500.117. Respiratory Care Practitioner. 

§97500.119. Service Area. 

§97500.121. Sterihzation. 

§ 97500.123. Supervision. 

§97500.125. Therapeutic Diet. 

Article 2. Required Services 1335 

§97510.1. Required Services. 

§ 97510.3. Medical Staff. 

§97510.5. Medical Director. 

§97510.7. Nursing Administration. 

§ 97510.9. Nursing Staff Levels. 

§ 97510.11 . Minimum Nursing Staff. 

§ 97510.13. Patient Care Policies and 

Procedures. 

§ 97510.15. Patient Recovery Care Plan. 

§97510.17. Nurses' Notes. 

§ 97510.19. Nursing Service — Administration of 

Medications and Treatments. 

§ 97510.21. Nursing Service — Cleaning, 

Disinfecting and Sterilizing. 

§97510.23. Nursing Service — Space. 

§ 97510.25. Pharmaceutical Service— Staff. 



Page xi 



(1-18-2008) 



Table of Contents 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



Article 



Page 

§ 97510.27. Pharmaceutical Service — Policies 

and Procedures. 
§ 97310.29. Pharmaceutical Service — General 

Requirements. 
§ 9751 0.3 1 . Order and Administration of Drugs. 

§ 97510.33. Disposition of Drugs. 

§ 97510.35. Pharmaceutical Service — Quality 

Control Procedures. 
§ 97510.37. Pharmaceutical 

Service — Equipment and Supplies. 
§ 97510.39. Pharmaceutical Service — Space. 

§ 9751 0.41 . Dietetic Service— Staff. 

§ 97510.43. Dietetic Service — Policies and 

Procedures. 
§ 97510.45. Dietetic Service — General 

Requirements. 
§ 97510.47. Dietetic Service — Outside Food 

Service. 

3. General Requirements 1339 

97520.1. Admission. 

§ 97520.3. Admission Planning. 

§ 97520.5. Admission Procedures. 

§ 97520.7. Post Admission Procedures. 

§ 97520.9. Extended Stay. 

§ 97520. 1 1 . Patient Discharge. 

§97520.13. Patient Transfer. 

§97520.15. Patient Rights. 

§ 97520.17. Consumer Information to be Posted. 

Article 4. Administration 1341 

Governing Body. 

Administrator. 

Medical Records. 

Content of Medical Records. 

Patient Record Keeping. 

Infection Control Program. 

Quality Assurance Program. 

Equipment and Supplies. 

Personnel Policies. 

Employee Personnel Records. 

Employees' Health Examination 

and Health Records. 

Housekeeping. 

Laundry. 

External Disaster and Mass Casualty 

Program. 

Fire and Internal Disasters. 

Reporting of Communicable 

Diseases. 

Reporting of Outbreaks. 

Unusual Occurrences. 

Program Flexibility. 

Article 5. Fees 1345 

§97540.1. Fees. 

Article 6. Operational Requirements 1345 

§ 97550.1 . Approval to Begin Operation. 

§ 97550.3. Compliance with Other Laws and 

Regulations. 

Article 7. Monitoring and Compliance 1345 

§97560.1. Patient Data. 

§ 97560.3. Cost and Charge Data. 

§ 97560.5. Administrative Data. 

§ 97560.7. Data Reporting. 

§ 97560.9. Access to Records and Facility 

Sites. 
§ 97560. 1 1 . Access to Surgery Programs. 

§ 97560.13. Inspection of Facilities. 

§97560.15. Reasons for 

SuspendingAVithdrawing Project 

Designation. 
§ 97560.17. Methods of Withdrawing or 

Suspending Demonstration Project 

Designation. 
§ 97560.19. Hearing Procedures. 



§97530.1. 
§ 97530.3. 
§ 97530.5. 
§ 97530.7. 
§ 97530.9. 
§97530.11. 
§97530.13. 
§ 97530.15. 
§ 97530.17. 
§ 97530.19. 
§97530.21. 

§ 97530.23. 
§ 97530.25. 
§ 97530.27. 

§ 97530.29. 
§97530.31. 

§ 97530.33. 
§ 97530.35, 
§ 97530.37, 



Page 

Article 8. Physical Plant 1346.1 

§ 97570. 1 . Physical Plant and Spatial 

Standards. 
§ 97570.3. Application for Plan Approval. 

§ 97570.5. Continuous Safe Structural 

Operation. 

Chapter 13. Mobile Cardiac Catheterization 

Pilot Project 1 347 

Article 1. Definitions 1347 

§97600.1. Mobile Van. 

§ 97600.3. Pilot Program. 

§ 97600.5. Interim Program. 

§ 97600.7. Designation Agreement. 

§ 97600.9. Interim Program Authorization 
Agreement. 

Article 2. Relationship Between Base 

and Host Hospital During 

Pilot Program Operation 1347 

§97601.1. Base Hospital and Host Hospital. 

§ 9760 1.3. Base and Host Hospital Patient 

Safety Assurance Procedures. 
§ 97601.5. Separate Requirements for Each 

Host Hospital. 

Article 3. General Provisions 1347 

§ 97602.1. Mobile Cardiac Catheterization 

Laboratory (Van) Physical 

Requirements. 
§ 97602.3. Staffing Requirements. 

§ 97602.5. Equipment Requirements. 

§ 97602.7. Drug Requirements. 

§ 97602.9. Emergency Protocol Requirements. 

§ 97603.1. Criteria for the Selection and 

Exclusion of Patients. 
§ 97603.3. Permitted Procedures and 

Minimums. 
§ 97603.5. Written Informed Consent. 

§ 97603.7. Maintenance and Update. 

Article 4. Interim Program Use of 

Mobile Lab When Replacing a 

Hospital Based Cardiac 

Catheterization Laboratory 1348 

§ 97604. 1 . Interim Use of Mobile Labs. 

Article 5. Monitoring and Record 

Keeping 1348 

§ 97605.1. Data and Patient Utilization. 

§ 97605.3. Access to Records and Facility Site. 

§ 97605.5. Reasons for 

SuspendingAVithdrawing Project 

Approval. 
§ 97605.7. Methods of 

SuspendingAVithdrawing Project 

Approval. 
§ 97605.9. Hearing Procedure. 

Article 6. Fees 1348 

§97606.1. Fees. 

Article 7. Operational Requirement 1348 

§ 97607.1. Operational Requirement. 

Article 8. Compliance with Other Laws 

and Regulations 1348 

§ 97608.1 . Compliance with Other Laws and 

Regulations. 

Chapter 14. Minority Health Professions 

Education Foundation 1349 

Article L Definitions 1349 

§ 97700. 1 . Academic Year. 



Page xii 



(1-18-2008) 



Title 22 



Health Planning and Facility Construction 



Table of Contents 



Page 



• 



§ 97700.2. 


Areas Deficient in Primary Care 




Services. 


§ 97700.3. 


Associate Degree Nursing Program. 


§ 97700.4. 


Baccalaureate Degree Nursing 




Program. 


§ 97700.5. 


Black. 


§ 97700.6. 


Contract or "Agreement." 


§ 97700.7. 


Default. 


§ 97700.8. 


Demographically Underrepresented 




Group. 


§97700.13. 


Dentist. 


§97700.13. 


Direct Financial Assistance. 


§97700.17. 


Direct Patient Care. 


§97700.18. 


Director. 


§97700.19. 


Economically Disadvantaged. 


§ 97700.20. 


Educational Loan. 


§97700.21. 


Family Practice. 


§ 97700.23. 


FuU-Time Student. 


§ 97700.25. 


Graduated Health Professional. 


§ 97700.26. 


Graduate Training Program or 




Postgraduate Training Program. 


§ 97700.27. 


Health Manpower Shortage Area. 


§ 97700.29. 


Hispanic/Latino. 


§97700.31. 


Letter of Understanding. 


§ 97700.32. 


Loan Repayment Commitment. 


§ 97700.33. 


Loan Repayment Program. 


§ 97700.35. 


Medically Underserved Area. 


§97700.41. 


Native American Indian. 


§ 97700.43. 


Other Health Professions. 


§ 97700.45. 


Other Persons Underrepresented. 


§ 97700.47. 


Participating School or Institution. 


§ 97700.49. 


Persons Who Agree in Writing. 


§97700.51. 


"Physician and Surgeon" or 




"Physician." 


§ 97700.53. 


Primary Care Services. 


§ 97700.55. 


Registered Nurse. 


§ 97700.57. 


Registered Nurse Education 




Program. 


§ 97700.59. 


Service Obligation. 


§97700.61. 


Scholarship. 


§ 97700.63. 


Underrepresented Minority Groups. 


§ 97700.65. 


Underrepresented Person. 


icle 2. 


General Provisions 


§ 97720. 


Application Process for Financial 




Assistance. 


§ 97722. 


Selection Process. 


§ 97724. 


Incompatible Existing Obligations. 


§ 97726. 


Conditions Under Which a 



Article 5. 

§ 97750. 

§ 97752. 

§ 97755. 

§ 97757. 

§ 97759. 

Article 6. 

§ 97760. 
Article 7. 

§ 97770. 



§97771. 
§ 97772. 



Chapter 15. 



§ 97800. 
§97810. 
§ 97820. 
§ 97830. 
§ 97840. 
§ 97850. 
§ 97860. 

§ 97870. 

§ 97880. 

§ 97890. 



Chapter 16. 



Page 

Registered Nurse Education 

Program 1 352.6 

Eligibility Criteria for Financial 

Assistance Under the Registered 

Nurse Education Program. 

Obligation of Registered Nurse 

Education Program Scholarship 

Recipient. 

Loan Repayment Provisions of the 

Registered Nurse Education 

Program. 

General Provisions for the 

Registered Nurse Education 

Program. 

Pilot Project for Associate Degree 

Nurses. 

Appeals 1352.7 

Appeals. 

Citizenship and Alien 

Verification Requirements 1352.8 

Limitations on the Public Benefits 

of Scholarships, Loans or Loan 

Repayments for Aliens. 

Form lA. 

Acceptable Documentation. 

Associate Degree Nursing 

Scholarship Program 1352.15 

Chapter Definitions. 

Available Funding. 

Duration of Scholarship Awards. 

Permissible Scholarship Costs. 

Application Process. 

Selection Process. 

Obligations of the Scholarship 

Recipient. 

Commencement of Service 

Obligation. 

Penalties for Failure to Comply with 

Requirements of Program. 

Exceptions to Service or Payment 

Obligations. 

Vocational Nurse Scholarship and 

Loan Repayment Program 1352.17 



Scholarship or Loan Repayment 
Obligation May Be Canceled, 
Reduced Waived or Suspended. 



Article 3. 


Scholarships 1352.4 


§ 97730. 


Eligibility Criteria for Scholarship 




Assistance. 


§97731. 


Duration of Scholarship Awards. 


§ 97732. 


Permissible Scholarship Costs and 




Amounts. 


§ 97734. 


Scholarship Payment and 




Suspension Provisions. 


§ 97735. 


Obligations of the Scholarship 




Recipient. 


§ 97737. 


Penalties for Non-Compliance by a 




Scholarship Recipient. 


Article 4. 


Loan Repayment Program 1352.6 


§ 97740. 


Eligibility Criteria for the Loan 




Repayment Program. 


§ 97743. 


Loan Repayment Program 




Provisions. 


§ 97745. 


Additional Loan Repayment 




Conmiitment Contracts. 


§ 97747. 


Penalties for Non-Compliance by a 




Loan Repayment Program 




Participant. 



Article 1. 


General Provisions 1352.17 


§ 97900. 


Chapter Definitions. 


§97901. 


Available Funding. 


§ 97902. 


Exceptions to Service or Payment 




Obligations. 


Article 2. 


Scholarship Program 




Provisions 1352.18 


§ 97910. 


Scholarship Eligibility. 


§97911. 


Duration and Terms of Scholarship 




Awards. 


§ 97912. 


Permissible Scholarship Costs. 


§97913. 


Scholarship Application Process. 


§ 97914. 


Selection Process. 


§ 97915. 


Disbursement of Scholarship 




Award. 


§ 97916. 


Service Obligation Provisions for 




Scholarship Recipient. 


§ 97917. 


Penalties for Failure to Comply with 




Requirements of Program. 


Article 3. 


Loan Repayment Program 




Provisions 1352.20 



§ 97920. 
§97921. 
§ 97922. 
§ 97923. 
§ 97924. 



Loan Repayment Eligibility. 
Loan Repayment Awards. 
Loan Repayment Contracts. 
Terms of Loan Repayment. 
Loan Repayment Application 
Process. 



Page xiii 



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Table of Contents 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



Page 



Page 



§ 97925. Selection Process. 

§ 97926. Service Obligation Provisions for 

Loan Repayment Recipient. 
§ 97927. Penalties for Failure to Comply with 

Requirements of Program. 

Chapter 17. Licensed Mental Health Service 

Provider Education Program 1352.21 

§ 97930. Chapter Defmitions. 

§ 97930. 1 . Available Funding. 

§ 97930.2. Loan Repayment Eligibility. 



§ 97930.3. 


Loan Repayment Awards. 


§ 97930.4. 


Loan Repayment Contracts. 


§ 97930.5. 


Terms of Loan Repayment. 


§ 97930.6. 


Loan Application Process. 


§ 97930.7. 


Selection Process. 


§ 97930.8. 


Service Obligation Provisions for 




Loan Repayment Recipient. 


§ 97930.9. 


Penalties for Failure to Comply with 




Requirements of Program. 


§ 97930.10. 


Exceptions to Service or Payment 




Obligations. 



Page xiv 



n-l 8-2008) 



Title 22 



Health Planning and Facility Construction 



§ 90029 



Division 7. Health Planning and Facility 
Construction 

(Originally Printed 10-9-76) 



Chapter 1. Health Planning and Resources 
Development 



Article 1. Definitions 



§ 90001 . Addition. 

NOTE: Authority cited: Sections 208, 437, 437.2. 437.5, 437.6, 437.7, 437.8, 
437.9, 437.10, 437.1 1, 437.12, 437.13, 438, 438.1, 438.2, 438.3, 438.4, 438.5, 
438.6,438.8,438.9,438.10,438.11,438.12,438.13, 1250. land 1268, Health and 
Safety Code, and Sections 1 1500 et seq.. Government Code. Reference: Chapter 
854, Statutes of 1976. 

History 

1. New Division 7, Chapter 1 (Sections 90001-90605, not consecutive) filed 
10-5-76 as an emergency; effective upon filing (Register 76, No. 41). 

2. Repealer and new Division 7, Chapter 1 (Sections 90001-90905, not consecu- 
tive) filed 1 1 -9-76 as an emergency ; effective upon filing (Register 76, No. 46). 

Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 

4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90002. Applicant. 

History 
I. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1 346.2(d) (Register 83, No. 42). 

§ 90003. Application. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90005. Adjacent. 

History 

1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90007. Area Agency. 

"Area agency" means an area health planning agency designated by 
the Council. 

Note: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tions 437.6, 437.7, 437.8, 437.15, 438.2, 438.3, 438.4, 438.5, 438.8, 439.5 and 
439.6, Health and Safety Code. 

History 

1. New NOTE filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90009. Area Plan. 

"Area Plan" means an area agency's plan found to be in conformance 
by the Council. 

NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tion 437.7, Health and Safety Code. 

History 
1. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90009.5. Capital Expenditure Threshold. 

NOTE: Authority cited: Sections 208, 437.10 and 438.6, Health and Safety Code. 
Reference: Sections 437.10 and 438.6, Health and Safety Code. 

History 

1. New section filed 4-10-78; effective thirtieth day thereafter (Register 78, No. 
15). 

2. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secdon 1 1346.2(d) (Register 83, No. 42). 



§ 9001 0. Cardiovascular Surgery Service. 

History 

1. New section filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 
37). 

2. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 11 346.2(d) (Register 83, No. 42). 

§ 9001 1 . Certified Cost Estimate. 

"Certified cost estimate" means an estimate of the total cost of a proj- 
ect certified by a qualified individual as specified in the applicable Office 
form. 

NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tions 437.10 and 437.1 1, Health and Safety Code. 

History 

1 . Amendment of subsection (a)(3) filed 12-8-76 as an emergency; effective upon 
filing (Register 76, No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 

3. Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

§90013. Certificate of Exemption. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 9001 5. Certificate of Need. 

History 
1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1346.2(d) (Register 83, No. 42). 

§ 90017. Community Need. 

"Community Need" means the facility health resources required to 
serve a given service area as set forth in the Statewide Health Facilities 
and Services Plan. 

NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tions 437.7 and 437.8, Health and Safety Code. 

History 
1. Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90019. Commencement of Construction. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1 346.2(d) (Register 83, No. 42). 

§ 90021 . Comparable Arrangement. 

NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tion 437.10, Health and Safety Code. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90023. Consumer. 

"Consumer" means a person who is not a provider as defined in Sec- 
tion 90051. 

NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tions 437, 437.7, 438.10 and 439.7, Health and Safety Code. 

History 

1. New NOTE filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90025. Council. 

History 
1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Secfion 11346.2(d) (Register 83, No. 42). 

§ 90027. Days. 

"Days" means calendar days unless otherwise specified. 
NOTE: Authority cited: Secfion 437.6, Health and Safety Code. Reference: Sec- 
tions 438.2 and 438.5, Health and Safety Code. 

History 

1. New NOTE filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90029. Department. 

Note: Authority cited: Sections 208, 437, 437.2, 437.5-437.13, 438, 
438.1-438.6, 438.8^38.13, 1250.1, 1268 and 1275, Health and Safety Code; 



Page 1191 



(4-1-90) 



§ 90031 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



Section 1 1500 et seq., Government Code. Reference: Chapter 1252, Statutes of 
1977. 

History 

1 . Amendment filed 6-30-78 as an emergency; desisnated effective at 1 1 :59 p.m. 
on 6-30-78 (Register 78, No. 26). 

2. Certificate ofCompliance transmitted to OAH 10-27-78: filed 10-3 1-78 (Reg- 
ister 78. No, 44). 

3. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§90031. Director. 

NOTE; Authority cited: Sections 208, 437, 437.2. 437.5-437.13, 438, 
438.1-438.6, 438.8-438. 1 3, 1 250. 1 , 1 268 and 1 275, Health and Safety Code; Sec- 
tions 1 1 500 et seq., Goveminent Code. Reference: Chapter 1 252. Statutes of 1 977. 

History 

1 . Amendment filed 6-30-78 as an emergency; desisnated effective at 1 1 :59 p.m. 
on 6-30-78 (Register 78, No. 26). 

2. Certificate of Compliance transmitted to OAH 10-27-78; filed 10-3 1-78 (Reg- 
ister 78, No. 44). 

3. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secnon 1 1346.2(d) (Register 83, No. 42). 

§ 90032. Division. 

"Division" means that division within the Office of Statewide Health 
Planning and Development which has responsibility for reviewing appli- 
cations for certificates of need. 

NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tion 438.5, Health and Safety Code. 

History 

1 . New section filed 5-17-83; designated effective 4-22-83 pursuant to Govern- 
ment Code Secfion 1 1349.3 (Register 83, No. 21). 

2. AmendmentofNOTE filed 10-14-83; designated effective 10-17-83 pursuant 
to Government Code Section 1 1346.2(d) (Register 83, No. 42). 

3. Amendment filed 2-28-85; effecfive thirtieth day thereafter (Register 85, No. 
9). 

§ 90033. Effective Date. 

History 

1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Secfion 11346.2(d) (Register 83, No. 42). 

§ 90035. Facility. 

"Facility" means either a health facility or a specialty clinic. 
NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tions 437.6, 437.8, 437.10, 437.12, 437.13 and 438, Health and Safety Code. 

History 

1. Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90037. Facility Health Resources. 

History 
1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1346.2(d) (Register 83, No. 42). 

§ 90038. Functionally Related. 

"Functionally related" means operationally interdependent or normal- 
ly used together in the performance of a single procedure. 
NOTE: Authority cited: Sections 437.6 and 446.2, Health and Safety Code. Refer- 
ence: Sections 437.10 and 437.13, Health and Safety Code. 

History 

1 . New secfion filed 3-1-78; effective thirtieth day thereafter (Register 78, No. 9). 

2. Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d)'^(Register 83, No. 42). 

§ 90039. Health Facility. 

"Health facility" means a facility described in Health and Safety Code 
Section 1250, or a psychiatric health facility, as described in Health and 
Safety Code Section 1275.1, or a chemical dependency recovery hospi- 
tal, as described in Health and Safety Code Section 1250.3. 
NOTE; Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tions 437.6, 437.8, 437.10, 437.12 and 437.13, Health and Safety Code. 

History 

1. Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 



§ 90041 . Health Planning Area. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90043. Health Systems Agency. 

History 
1 . Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1346.2(d)"(Register 83, No. 42). 

§ 90044. Immediately Adjacent. 

NOTE; Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tion 437.13, Health and Safety Code. 

History 

1 . New section filed 3-1-78; effective thirtieth day thereafter (Register 78, No. 9). 

2. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 11346.2(d)7Register 83, No. 42). 

3. Repealer filed 7-1 1-84; effective thirtieth day thereafter (Register 84, No. 28). 

§ 90045. Local Area. 

History 
1 . Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1346.2(d) (Register 83, No. 42). 

§ 90046. Local Agency. 

History 

1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90047. Modernization. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1 346.2(d) (Register 83, No. 42). 

§ 90049. Person. 

"Person" includes a natural person, firm, business, trust, partnership, 
association, corporation, organization, or public entity. 
NOTE; Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tions 19 and 438.9, Health and Safety Code. 

History 
1. New NOTE filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90051 . Provider. 

(a) "Provider" includes but shall not be limited to the following types 
of individuals who: 

(1) Are engaged in the provision of health care to individuals, in the 
administration of health facilities, or in the administration of related 
health organizations. Such individuals shall, when required by law, be li- 
censed in California or certified by the appropriate national professional 
association or have received professional education or training in prepa- 
ration for licensure or certification. 

(2) Hold a fiduciary position with or has fiduciary interest in one of the 
following: 

(A) Health facilities or related health organizations engaged in the pro- 
vision of health care. 

(B) Educational institutions engaged in health related research and 
education. 

(C) Manufacturer or producer, including related associations and or- 
ganizations, of drugs or health related articles. 

(3) Receive directly or through a spouse more than 10 percent of their 
gross annual income from any one or combination of the following: 

(A) Fees or other compensations received from an educational institu- 
tion for performing research or instruction related to the provision of 
health care. 

(B) Health facilities, related health organizations engaged in the provi- 
sions of health care and education institutions engaged in health related 
research and education. 



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(C) Manufacturers or producers, including related associations and or- 
ganizations, of drugs or health related articles. 

(4) Are engaged in issuing any health insurance policy or contract for 
individuals, group medical service benefits, health facilities or related 
health organizations. 

(5) Are members of the immediate family of an individual defined as 
a provider. 

NOTE: Authority cited: Section 437.6, Health ajid Safety Code. Reference: Sec- 
tions 437, 437.7 and 439.7, Health and Safety Code. 

History 

1. New NOTE filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90052. Replacement. 

NOTE: Authority cited: Sections 437.6 and 446.2, Health and Safety Code; and 
Section 1 1 1 52, Government Code. Reference: Sections 437. 1 and 437. 1 3, Health 
and Safety Code. 

History 

1. New section filed 5-17-83; designated effective 4-22-83 pursuant to Govern- 
ment Code Section 1 1349.3 (Register 83, No. 21). 

2. Repealer filed 7-1 1-84; effective thirtieth day thereafter (Register 84, No. 28). 

§ 90053. Service Area. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90057. Services. 

History 
1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90058. Specialty Clinic. 

NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tions 437.6 and 437.10, Health and Safety Code. 

History 

1. New section filed 5-17-83; designated effective 4-22-83 pursuant to Govern- 
ment Code Section 1 1349.3 (Register 83, No. 21). 

2. Amendment ofNOTE filed 10-14-83; designated effecfive 10-17-83 pursuant 
to Government Code Secfion 1 1346.2(d) (Register 83, No. 42). 

3. Repealer filed 7-1 1-84; effective thirtieth day thereafter (Register 84, No. 28). 

§ 90059. Statewide Health Facilities and Services Plan. 

History 
1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90060. Undertake. 

(a) "Undertake" means any of the following: 

(1) Remodeling, installing, operating, continuing, acquiring, any com- 
bination of the aforementioned, or otherwise proceeding with a project 
or any part of a project. 

(2) The obligation of an expenditure, an expenditure, or commitment 
of funds for a project which shall include but not be limited to: 

(A) Construction of the project. 

(B) Equipment orders, purchases, leases or acquisition through other 
comparable arrangements or donation. 

(C) Provision of services through contract, lease or comparable ar- 
rangement. 

(D) Development of preliminary plans and outline specifications an- 
ticipated to cost more than the capital expenditure threshold. 

(E) Obtaining financing for a specified project where the financing is 
not contingent upon certificate of need or certificate of exemption ap- 
proval. 

(F) Executing contracts for the project which are not contingent upon 
certificate of need or certificate of exemption approval. 

(b) The expenditure or commitment of funds to develop applications, 
studies, reports, schematics, long range planning or preliminary plans 
and outline specifications anticipated to cost not more than the capital ex- 
penditure threshold shall not be considered to be the undertaking of a 
project. 



NOTE: Authority cited: Section 437.6, Health and Safety Code; Reference: Sec- 
tion 438.6, Health and Safety Code. 

History 

1 . New secfion filed 12-8-76 as an emergency; effecfive upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 

3. Amendment of subsection (a)(2) filed 9-8-77; effective thirtieth day thereafter 
(Register 77, No. 37). 

4. Amendment of subsections (a)(2)(D) and (b) filed 4-10-78; effective thirtieth 
day thereafter (Register 78, No. 15). 

5. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
emment Code Secfion 1 1346.2(d) (Register 83, No. 42). 

§ 90061. Voluntary Area Health Planning Agency. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code 1 1346.2(d) (Register 83, No. 42). 

§ 90063. Voluntary Local Health Planning Agency. 

History 

1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Secfion 11346.2(d) (Register 83, No. 42). 



Article 2. Advisory Health Council 

§ 901 01 . Council Functions. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secfion 11346.2(d) (Register 83, No. 42). 

§ 90103. Designation of Health Planning Area. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secfion 11346.2(d) (Register 83, No. 42). 

§ 90105. Designation of Area Agency. 

The Council shall evaluate and designate at least annually , but no later 
than June 30, one area agency for each health planning area of the State. 
NOTE: Authority cited: Secfion 437.6, Health and Safety Code. Reference: Sec- 
tion 437.7, Health and Safety Code. 

History 
1 . Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Secfion 11346.2(d) (Register 83, No. 42). 

§ 90107. Criteria for Designation of Area Agencies. 

(a) The Council, in designating area agencies, shall consider but not 
be limited to the following criteria. Area agencies shall: 

(1) Have Office-approved written policies relating to the performance 
of functions under this chapter which shall include but not be limited to 
provisions for: 

(A) A board of directors, or governing body including the duties, num- 
ber, and qualificafions of members. 

(B) Membership composition of the board of directors or governing 
body which sets forth that: 

J . Both the consumer membership and the provider membership shall 
be broadly representative of the community and to the maximum extent 
possibleshallberepresentativeof social, economic, linguistic, and racial 
populations in the proportion in which they exist in the population of the 
area. 

2. The membership should be broadly representative of the provider 
community and the major purchasers of health care in the area. 

3. Members shall be residents of the area and be broadly representative 
of geographic subdivisions. 

(C) Replacement of members, including term of office, replacement 
due to expiration of term, vacancies, removals, absenteeism, resignation, 
and death. 

(D) Standing committees and ad hoc or task force groups. 

(E) Conflict of interest and incompatible activities, including: 

1. A statement substantially similar to the Office's Incompatible Acti- 
vities Statement. 



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2. A mechanism for financial disclosure by designated officers, em- 
ployees, and consultants substantially similar to that found in the Office' s 
Conflict of Interest Code. 

3. A disqualification mechanism substantially similar to that found in 
the Office's Conflict of Interest Code. 

(F) Training of vokinteers serving on review and planning commit- 
tees. 

(G) Responsibilities of the board of directors or governing body, in- 
cluding provisions that the governing body shall: 

1 . Have adequate resources to augment the funds allocated by the Of- 
fice to perform the functions required by this chapter. Such resources 
shall not be from any nongovernmental source which has a financial, fi- 
duciary, or other interest in the development, expansion, operation, 
maintenance, or support of health resources unless the source is an entity 
described in Section 509(a) of the Internal Revenue Code of i 954 and the 
entity is not directly engaged in the provision of health care in the agency 
area. 

2. Have separate budgets for planning and for project review. 

3. Demonstrate a capability for fulfilling satisfactorily the functions 
set forth in this chapter. 

4. Assure to the greatest extent possible community support. 

5. Have an affirmative action plan and a policy of nondiscrimination 
in performing the activities of the agency in accordance with the provi- 
sions of this chapter. 

(2) Be able and willing to contract with the Office. 
NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tion 437.7, Health and Safety Code. 

History 

1 . Amendment of subsection (a)(1)(B) and new subsection (a)(2) filed 9-8-77; ef- 
fective thirtieth day thereafter (Register 77, No. 37). 

2. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 901 09. Criteria for Evaluation of Area Agencies. 

(a) The Council shall make at least an annual evaluation of area agen- 
cies for the purpose of designating such area agencies. The evaluation 
shall determine if the area agency: 

(1) Performs satisfactorily all functions required by this chapter. 

(2) Carries out activities in accordance with Office policies regarding 
health care cost containment, and unnecessary duplication of facilities, 
services, and equipment. 

(3) Follows the approved affirmative action employment plan. 

(4) Demonstrates an effective and efficient expenditure for planning 
and project review. 

(5) Meets coordinated work schedules established by the Office in de- 
veloping health facilities and services plans. 

(6) Demonstrates and shows evidence of cooperation with: 

(A) Governmental entities, such as county health agencies. 

(B) Nonprofit health planning entities and community organizations. 

(7) Follows written policies as prescribed by Section 90107. 
NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tion 437.7, Health and Safety Code. 

History 
1. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 11346.2(d) (Register 83, No. 42). 

§ 901 1 0. Nondiscrimination and Affirmative Action. 

(a) Area agencies shall take affirmative action to ensure that em- 
ployees and applicants for employment are not discriminated against on 
the basis of their race, color, religion, creed, national origin, sex, age, or 
physical or mental handicap, or any other factors which may unlawfully 
place an individual or group at a disadvantage while employed or while 
seeking employment. Such affirmative action shall include, but not be 
limited to, the following: 

(1) Employment. 

(2) Promotion. 

(3) Demotion or transfer. 



(4) Recruitment or recruitment advertising. 

(5) Layoff or termination. 

(6) Rates of pay or other forms of compensation. 

(7) Selection for training. 

(b) Area agencies shall follow standardized hiring procedures as de- 
fined below by the Office. Such procedures shall include but not be lim- 
ited to: 

(1) Length of time for filing notices of vacancies. 

(2) Length of time for advertising positions. 

(3) Number and types of advertising to be done. 

(4) Procedures for providing fair consideration to all applicants. 

(c) Area agencies shall initially submit an affirmative action plan to the 
Office. Thereafter, area agencies shall annually submit modifications, if 
any, to the Office of Statewide Health Planning and Development. The 
affirmative action plan shall include, but not be limited to, the following: 

(1 ) A demographic statistical summary of the ethnic groups in the area 
served by the area agency. 

(2) A requirement that existing area agency offices, meeting places, 
and related premises, and existing area agency facilities to be remodeled, 
shall be accessible to and useable by the handicapped, including individ- 
uals in wheelchairs. 

(3) An accessibility review-report prepared by the Mobihty Barriers 
Section of the Department of Rehabilitation or by an appropriate local or- 
ganization certified by tliis section. An acceptable defense for failure to 
meet the requirement of this paragraph is the Department of Rehabilita- 
tion' s failure to compile such a report. 

(4) Procedures to ensure that reasonable job accommodations are 
made for disabled employees and applicants. 

(5) Provision for the accessibility to offices, meeting places, and re- 
lated premises and transportation. 

(6) Procedures to ensure that there are no communication barriers that 
would exclude the disabled. For the purposes of this section, communica- 
tion barriers shall include the absence of such things as Braille markings 
on elevators and amplification equipment for telephones. 

(7) Evidence that meetings are public and are accessible to the public. 

(8) Evidence that advisory committees, governing bodies or boards of 
directors are composed of persons representative of the service area in- 
cluding ethnic minorities, women, aged, and the handicapped. 

(9) Evidence that the area agency posts in a conspicuous place avail- 
able to employees notices of the policy of nondiscrimination. 

(10) Name of person within the area agency who will be responsible 
for the implementation of the affirmative action plan. The responsible 
person shall: 

(A) Assist the governing body or board of directors in developing a 
pohcy statement. 

(B) Assist in identifying problem areas. 

(C) Assist line management in implementing the plan. 

(D) Design and implement a reporting system that will measure the ef- 
fectiveness of the affirmative action plan. 

(1 1) A work force analysis which identifies for each job title or classi- 
fication the total number of male and female incumbents in each of the 
following groups: Blacks, Spanish-Speaking/Spanish Surname, Ameri- 
can Indians, Asian and Pacific people (specify), Filipinos, the handi- 
capped, and others. An analysis shall include an explanation if minori- 
ties, women, or handicapped persons are currently being under-utihzed 
in any one or more job classifications. 

(12) Employment goals which are attainable and which are designed 
to achieve timely results with respect to the employment deficiencies 
identified in the workplace analysis. Such goals and timetable with sup- 
porting data and the analysis thereof shall also be a part of the area 
agency ' s written affirmative action plan and shall be available to the pub- 
lic at the area agency office. 

(d) Area agency affirmadve action plans shall establish a mechanism 
for the prompt investigation and resolution of all complaints of discrimi- 
nation in employment practices. Initial attempts at resolution should take 
place at the area agency. The area agency shall make this complaint pro- 



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cess available to all employees or applicants for employment. The com- 
plainant shall have the right of appeal from the local decision to the Civil 
Rights Office of the Office. The area agencies shall, subject to the ap- 
proval of the Office, establish procedures under which complainants are 
informed of their rights to file a complaint alleging discrimination in ei- 
ther employment or service in violation of their civil rights with the Of- 
fice. This notice shall be posted in the languages of significant numbers 
(5% or more) of the population residing in the area. Complaints nor re- 
solved at the area agency level alleging discrimination in employment by 
the area agency because of race, color, national origin, creed, sex, age, 
or physical or mental handicap, will be resolved by the Office' s Affirma- 
tive Action Complaint Process. 

(e) If the area agency has not developed an acceptable affirmative ac- 
tion plan, the Civil Rights Officer shall notify the Director. The Director 
will declare the area agency's affirmative action plan non-responsive 
and notify the Council. If the area agency fails to show good cause for its 
failure or fails to remedy that failure by developing and implementing an 
acceptable action plan, the Office shall take appropriate action. 
NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tion 437.7, Health and Safety Code. 

History 

1 . New section filed 12-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Cenificate of Compliance filed 3-8-77 (Register 77, No. 11). 

3. Amendment of subsection (c) filed 1-11-82; effective thirtieth day thereafter 
(Register 82, No. 3). 

4. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Section Code 11346.2(d) (Register 83, No. 42). 

§ 90111. Approval of Local Health Planning Areas. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 



Article 3. Area Health Planning Agencies 

§ 90201 . Area Agency Functions. 

History 
1 . Repealer of Article 3 (Sections 90201-90205, not consecutive) filed 10-14-83; 
designated effective 10-17-83 pursuant to Government Code Section 
1 1 346.2(d) (Register 83, No. 42). For prior history, see Register 77, No. 37. 



Article 4. Office Functions 

§ 90301 . Functions of the Department. 

History 

1. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

2. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90303. Responsibilities Relating to Statewide Policies. 

History 

1. Amendment filed 12-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90304. Plan Development Guidelines. 

(a) The 1980-81 Plan Development Guidelines as adopted by the Of- 
fice of Statewide Health Planning and Development in accordance with 
requirements of this division are incorporated in this article by this refer- 
ence. 



(b) Such Guidelines shall be reviewed, and revised as necessary, by the 
Office, on an annual basis in accordance with the provisions of the Ad- 
ministrative Procedures Act. 

(c) Copies of the adopted guidelines may be reviewed in the Office of 
Statewide Health Planning and Developinent, 714 "P" Street, Room 
1050, Sacramento, California 95814. It having been found that the print- 
ing of the regulation constituting the 1 980-81 Plan Development Guide- 
lines would be impractical and that the regulation would be of limited and 
particular application, pursuant to Government Code, Section 1 1409(a), 
the regulation is not pubhshed in full in the California Administrative 
Code. 

Note: Authority cited: Sections 208, 437.6. and 437.8, Health and Safety Code, 
and Section 21000 et seq.. Public Resources Code. Reference: Section 437.8, 
Health and Safety Code, Section 21 102, Public Resources Code; and Chapter 854, 
Statutes of 1976 as amended by Chapter 429, Statutes of 1978 and Chapter i 1 86, 
Statutes of 1979. 

History 

1. New section filed 12-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 1 1). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

4. Amendment filed 6-14-78; effective thirtieth day thereafter (Register 78, No. 

24). 

5. New subsection (a)(] 4) filed 4-1 1-80; effective thirtieth day thereafter (Regis- 
ter 80, No. 15). 

6. Repealer and new section filed 5-22-80; effective thirtieth day thereafter (Reg- 
ister 80, No. 21). 

7. Amendment filed 2-6-81 ; effective thirtieth day thereafter (Register 81 , No. 6). 

8. Amendment filed 4-30-81 ; effective thirtieth day thereafter (Register 81 , No. 
18). 

§ 90305. Policies for Facility and Services Planning. 

NOTE: Authority cited: Sections 437.8, 1203, 1255, Health and Safety Code. Ref- 
erence: Chapter 854, Statutes of 1 976 as amended by Chapter 429, Statutes of 1 978 
and Chapter 1 186, Statutes of 1979. 

History 

1 . New section filed 1 2-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

4. Repealer filed 5-22-80; effective thirtieth day thereafter (Register 80, No. 21). 

§ 90307. Policies Relating to Health Facilities. 

NOTE: Authority cited: Sections 437.8, 1203, 1255, Health and Safety Code. Ref- 
erence: Chapter 854, Statutes of 1 976 as amended by Chapter 429, Statutes of 1 978 
and Chapter 1 186, Statutes of 1979. 

History 

1. New section filed 12-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 1 1). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

4. Repealer filed 5-22-80; effective thirtieth day thereafter (Register 80, No. 21). 

§ 90309. Statewide Policies for General Acute Care. 

NOTE: Authority cited: Sections 207 and 437.8, Health and Safety Code. Refer- 
ence: Chapter 854, Statutes of 1976 as amended by Chapter 429, Statutes of 1978 
and Chapter 1 186, Statutes of 1979. 

History 

1. New Section filed 6-14-78; effective thirtieth day thereafter (Register 78, No. 
24). 

2. Repealer filed 5-22-80; effecfive thirtieth day thereafter (Register 80, No. 21). 

§ 9031 1 . Statewide Policies for Acute Psychiatric Care. 

NOTE; Authority cited: Sections 208 and 437.8, Health and Safety Code. Refer- 
ence: Chapter 854, Statutes of 1976 as amended by Chapter 429, Statutes of 1978 
and Chapter 1 186, Statutes of 1979. 

History 

1. New section filed 6-14-78; effective thirtieth day thereafter (Register 78, No. 
24). 

2. Repealer filed 5-22-80; effective thirtieth day thereafter (Register 80, No. 21). 



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§ 90313. Statewide Policies for Special and Supplemental 
Services. 

NOTE: Authority cited: Sections 208 and 437.8, Health and Safety Code. Refer- 
ence: Chapter 854, Statutes of 1 976 as amended by Chapter 429, Statutes of 1978 
and Chapter 1 186, Statutes of 1979. 

History 

1 . New section filed 6-14-78; effective thirtieth day thereafter (Reeister 78, No. 
24). 

2. Repealer filed 5-22-80; effective thirtieth day thereafter (Register 80, No. 21). 

§ 90315. Statewide Policies for Health Facilities Providing 
Long-Term Care. 

NOTE: Authority cited: Sections 208 and 437.8, Health and Safety Code. Refer- 
ence: Chapter 854, Statutes of 1976 as amended by Chapter 429, Statutes of 1978 
and Chapter 1 186, Statutes of 1979. 

History 

1 . New section filed 6- 14-78-. effective thirtieth day thereafter (Register 78, No. 
24). 

2. Repealer filed 5-22-80; effecfive thirtieth day thereafter (Register 80, No. 21). 

§ 90317. Statewide Method for Calculating Resource 
Requirements. 

NOTE: Authority cited: Sections 208 and 437.8, Health and Safety Code. Refer- 
ence: Chapter 854. Statutes of 1976 as amended by Chapter 429, Statutes of 1978 
and Chapter 1 186, Statutes of 1979. 

History 

1. New section filed 6-14-78; effective thirtieth day thereafter (Register 78, No. 
24). 

2. Editorial correction (Register 78, No. 40). 

3. Repealer filed 5-22-80; effective thirtieth day thereafter (Register 80, No. 21). 



Article 5. Certificate of Need 

§ 90401 . Projects Requiring a Certificate of Need. 

NOTE: Authority cited: Secfion 437.6, Health and Safety Code. Reference: Sec- 
tion 437.10, Health and Safety Code. 

History 

1. Amendment of subsecfions (c)(4) and (c)(10)(A) filed 3-1-78; effective thir- 
tieth day thereafter (Register 78, No. 9). For prior history, see Register 77, No. 
22. 

2. Editorial correction (Register 78, No. 9). 

3. Amendment of subsections (c)(10) and (c)(l 1)(A) filed 4-10-78; effecfive thir- 
tieth day thereafter (Register 78, No. 15). 

4. Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Secfion 11346.2(d) (Register 83, No. 42). 

5. Repealer filed 7-1 1-84; effective thirtieth day thereafter (Register 84, No. 28). 

§ 90403. Projects Exempt from Certificate of Need Review 
Procedures. 

History 
1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90407. Projects Necessary Because of Disaster or Other 
Emergency. 

NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
fion 437.11, Health and Safety Code. 

History 

1. Amendment of subsecfions (d) and (h) filed 5-25-77; effecfive thirtieth day 
thereafter (Register 77, No. 22). 

2. Amendment of subsecfion (t) filed 9-8-77; effective thirtieth day thereafter 
(Register 77, No. 37). 

3. Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Secfion 11346.2(d) (Register 83, No. 42). 

4. Repealer filed 7-1 1-84; effecfive thirtieth day thereafter (Register 84, No. 28). 

§ 90409. Projects to Comply with Law or Regulation. 

NOTE: Authority cited: Secfion 437.6, Health and Safety Code. Reference: Sec- 
fion 437.11, Health and Safety Code. 

History 

1 . Amendment of subsecfion (c)(4) filed 12-8-76 as an emergency; effecfive upon 
filing (Register 76, No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 



3. Amendment filed 5-25-77; effecfive thirtieth day thereafter (Register 77, No. 

22). 

4. Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Secfion 1 1346.2(d) (Register 83, No. 42). 

5. Repealer filed 7-1 1-84; effective thirtieth day thereafter (Register 84, No. 28). 

§ 9041 1 . Projects Under the Capital Expenditure 
Threshold. 

NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
fion 437.10, Health and Safety Code. 

History 

1 . Amendment filed 4-10-78; effective thirtieth day thereafter (Register 78, No. 
15). 

2. Amendment filed 10-14-83; designated effecfive 10-17-83; pursuant to Gov- 
ernment Code Secfion 11346.2(d) (Register 83, No. 42). 

3. Repealer filed 7-1 1-84; effective thirtieth day thereafter (Register 84, No. 28). 

§ 9041 2. Establishment and Adjustment of the Capital 
Expenditure Threshold. 

NOTE: Authority cited: Secfions437.6, 437. lOand 446.2, Health and Safety Code; 
Secfion 1 1 152, Government Code. Reference: Secfion 437.10, Health and Safety 
Code. 

History 

1 . New secfion filed 4-10-78; effecfive thiitieth day thereafter (Register 78, No. 
15). 

2. Amendment filed 4-26-79; effective thirtieth day thereafter (Register 79, No. 
17). 

3. Amendment restoring subsection (b) (inadvertently repealed by 4-26-79 order) 
filed 5-4-79; effecfive thirtieth day thereafter (Register 79, No. 17). 

4. Amendment of subsecfion (a) filed 7-11-80; effective thiitieth day thereafter 
(Register 80, No. 28). 

5. Amendment of subsection (a) filed 8-26-81; effective thirtieth day thereafter 
(Register 81, No. 35). 

6. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§90413. Notice of Intent. 

(a) Except as provided in Health and Safety Code Section 437.15 any 
person with an intent to apply for a certificate of need shall submit a no- 
tice of intent to the Office and the appropriate area agency at least 30 days 
prior to the submission of an application. 

(b) The notice of intent shall be delivered or sent to the Office of State- 
wide Health Planning and Development, at 1600 9th Street, Sacramento, 
California 95814. 

(c) The notice of intent shall include: 

(1) Description of the project, including location. 

(2) Estimated cost. 

(3) Anticipated filing date of application. 

(4) If available, information concerning the status of any EIR (Envi- 
ronmental Impact Report) or negative declaration prepared, in prepara- 
tion, or planned with respect to the project. 

(5) Names of lead agency and responsible agencies designated with re- 
spect to the project, if known. 

(d) The notice of intent shall expire after six months, except that upon 
the applicant's written request to the Office and concurrent notification 
of the area agency the notice will be extended for an additional six 
months. Such request shall be valid only if received by the Office before 
expiration of the notice. 

(e) The Office, for good cause shown, may shorten or waive the period 
in subdivision (a) above. 

NOTE: Authority cited: Section 437.6 and 438.3, Health and Safety Code. Refer- 
ence: Secfion 438.3, Health and Safety Code. 

History 

1. Amendment filed 9-8-77; effecfive thirtieth day thereafter (Register 77, No. 
37). 

2. Amendment filed 4-11-80; effecfive thirtieth day thereafter (Register 80, No. 
15). 

3. Repealer of subsection (g) filed 4-9-82; effective thirtieth day thereafter (Reg- 
ister 82, No. 15). 

4. Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

5. Amendment of subsecfions (a) and (e) filed 2-28-85; effective thirtieth day 
thereafter (Register 85, No. 9). 



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§ 90419 



§90415. Application Fee. 

(a) Each application for a certificate of need shall be accompanied by 
a remittance, except those exempted by law, the amount to be the sum of 
the appropriate base fee and project fee, as indicated below: 

(1) Base fee: 

General Acute Care Hospital $500.00 

Acute Psychiatric Hospital $500.00 

Special Hospital $500.00 

General Acute Care/Rehabilitation Hospital $500.00 

Psychiatric Health Facility $500.00 

Chemical Dependency Recovery Hospital $500.00 

Skilled Nursing Facility $350.00 

hitermediate Care Facility $350.00 

Small Intermediate Care Facility/ 

Developmentally Disabled Habilitative $350.00 

Specialty Clinic $200.00 

(2) Project fee, applicable to all facilities except small intermediate 

care facility/developmentally disabled habilitative: 

Project Cost Fee 

$0 to $1,999,999 $1,000 

$2,000,000 to $2,999,999 $2,000 

$3,000,000 to $3,999,999 $3,000 

$4,000,000 to $4,999,999 $4,000 

$5,000,000 and over $4,500 

(b) The project fee shall be adjusted when the Office verifies the cost 
estimate for the project. 

(c) The applicant shall submit any additional project fee required fol- 
lowing the verification by the Office of the cost estimate for the project. 
NoTE: Authority cited: Sections 437.6 and 438. 1, Health and Safety Code. Refer- 
ence: Section 438.1, Health and Safety Code. 

History 

1. Amendment filed 1 1-19-81; effective thirtieth day thereafter (Register 81, No. 
47). 

2. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section It 346.2(d) (Register 83, No. 42). 

§ 90416. Fee for Preparation of EIR or Negative 
Declaration. 

The Office may require a fee, in addition to that required under Section 
9041 5, to pay costs of preparing an EIR or a negative declaration for any 
project not found to be exempt from CEQA and for which the Office is 
the lead agency. The applicant shall remit this fee, in accordance with the 
Office's estimate of costs, before the application is declared complete. 
The fee shall be adjusted as necessary to reflect actual costs of preparing 
the EIR or negative declaration. Any excess shall be promptly refunded 
to the applicant. 

NOTE: Authority cited: Sections 437.6 and 438.1, Health and Safety Code; and 
Secfion 21089, Public Resources Code. Reference: Section 438.1, Health and 
Safety Code; and Section 21089, Public Resources Code. 

History 

1. New section filed 4-1 1-80; effective thirtieth day thereafter (Register 80, No. 
15). 

2. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Secdon 11346.2(d) (Register 83, No. 42). 

§90417. Special Fees. 

(a) Health Facilities, except those exempt by law and long-term care 
facilities (as defined by Section 97005(d), California Code of Regula- 
tions), shall be charged a special fee as follows: 

(1) For the last fiscal year ending on or before June 30, of the preceding 
calendar year the fee shall be 0.034 percent of the gross operating cost 
for the provision of health care services as determined by the Office. 

(b) Long-term care facilities (as defined by Section 97005(d), Califor- 
nia Code of Regulations), except those exempt by law, shall be charged 
a special fee as follows: 

( 1 ) For the last fiscal year ending on or before June 30, of the preceding 
calendar year, the fee shall be 0.034 percent of the gross operating cost 
for the provision of health care services as determined by the Office. 

(c) Freestanding ambulatory surgery clinics as defined in Health and 
Safety Code 128700(e) shall be charged a special fee that shall be estab- 
lished at an amount equal to the number of ambulatory surgery data re- 



cords submitted to the Office pursuant to Section 128737 for encounters 
in the preceding calendar year multiplied by fifty cents ($.50). 
NOTE; Authority cited: Sections 1 27 150, 127280, 1 28700 and 1 288 1 0, Health and 
Safety Code. Reference: Sections 127280 and 128737, Health and Safety Code. 

History 

1 . Amendment filed 5-25-77; effective thirtieth day thereafter (Register 77, No. 
22). 

2. Repealer and new section filed 5-22-80; effective thirtieth day thereafter (Reg- 
ister 80, No. 21). 

3. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

4. Amendment filed 6-8-84: effective upon filing pursuant to Government Code 
Section 1 1346.2(d) (Register 84, No. 23). 

5. Amendment of subsecfion (a)(1) filed 6-21-85; effective upon filing pursuant 
to Government Code Section lL346.2(d) (Register 85, No. 25). 

6. Amendment of subsection (a)(1) filed 6-24-86; effective upon filing pursuant 
to Government Code Section 1 1346.2(d) (Register 86, No. 26). 

7. Amendment of subsection (a)(1) filed 6-10-87; operative 6-10-87 (Register 
87, No. 25). 

8. Amendment of Subsection (a)(1) filed 2-15-89; operative 3-12-89 (Register 
89, No. 8). 

9. Amendment of subsections (a) and (a)(1), new subsections (b) and (b)(1), and 
amendment of Note filed 3-31-99 as an emergency; operative 3-31-99 (Reg- 
ister 99, No. 14). A Certificate of Compliance must be transmitted to OAL by 
7-29-99 or emergency language will be repealed by operation of law on the fol- 
lowing day. 

10. Editorial conection of subsection (b) (Register 99, No. 21). 

11. Certificate of Compliance as to 3-31-99 order transmitted to OAL 6-1 1-99 
and filed 7-2-99 (Register 99, No. 27). 

12. Amendment of subsections (a)(1) and (b)(1) filed 4-26-2004 as an emergen- 
cy; operative 4-26-2004 (Register 2004, No. 1 8). A Certificate of Compliance 
must be transmitted to OAL by 8-24-2004 or emergency language will be re- 
pealed by operation of law on the following day. 

13. Certificate of Compliance as to 4-26-2004 order transmitted to OAL 
7-13-2004 and filed 8-5-2004 (Register 2004, No. 32). 

14. Amendment of subsecfions (a)(1) and (b)(1) filed 6-30-2005; operative 
6-30-2005 pursuant to Government Code section 1 1343.4 (Register 2005, No. 
26). 

15. New subsecfion (c) and amendment of Note filed 11-21-2006; operative 
11-21-2006 pursuant to Government Code section 11343.4 (Register 2006, 
No. 47). 

§ 90419. Application Submission. 

(a) Any person may submit to the Office an application for a certificate 
of need, provided that the required notice period has passed since the re- 
ceipt by the Office of a notice of intent for the project or provided the Of- 
fice has waived the notice of intent requirement. 

(b) A single application may be filed for a project that includes more 
than one acUon listed individually in Health and Safety Code Section 
437. 10 when the entire project can be shown by the applicant to be inter- 
dependent. As used in this section, "interdependent" shall mean insever- 
able for purposes of making a decision. 

(c) An applicant may submit two or more applications simultaneously 
and request the Office to process the applications together. For each 
application submitted a separate fee shall be paid. 

(d) The applicant shall submit an original and the required copies of 
the application (not to exceed five copies) to the specific address identi- 
fied by the Office. Such application shall be on the forms and in the man- 
ner prescribed by the Office and shall be accompanied by the required 
fee. 

(e) The applicant shall, concurrently with submission to the Office, 
submit the number of copies required by the area agency, not to exceed 
ten copies. 

(f) The applicant shall submit with the application evidence regarding 
all of the applicable criteria set forth in Article 1 1 . 

(g) The applicant's failure to respond within six months to notification 
that the application is incomplete shall constitute withdrawal of the appli- 
cation. 

Note: Authority cited: Secfions 437.6, 438, 438.1, 438.3, 439 and 446.2, Health 
and Safety Code. Reference: Secfions 438, 438.1 , 438.3 and 439, Health and Safe- 
ty Code. 

History 
1. Amendment filed 5-25-77; effective thirtieth day thereafter (Register 77, No. 
22). 



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§ 90420 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



2. Aniendment of subsection (d) filed 9-8-77; effective thirtieth day thereafter 
(Register 77, No. 37). 

3. Amendment of subsection (d) tiled 1-1 1-82; effective thirtieth day thereafter 
(Register 82, No. 3). 

4. Repealer of subsection (f) filed 4-9-82; effective thirtieth day thereafter (Regis- 
ter 82, No. 15). 

5. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 11346.2(d)''(Register 83, No. 42). 

§ 90420. Projects Not Directly Related to Patient Care. 

Note-. Authority cited: Sections 437.6, 437. 1 5 and 438, Health and Safety Code. 
Reference: Sections 437.15 and 438.3, Health and Safety Code. 

History 

1 . New section filed 5-17-83; designated effective 4-22-83 pursuant to Govern- 
ment Code Section 1 1349.3 (Register 83, No. 21). 

2. Amendment of NOTE filed 10-14-83: designated effective 10-1 7-83 pursuant 
to Government Code Section 1 1346.2(d) (Register 83. No. 42). 

3. Repealer filed 7-1 1-84; effective thirtieth day thereafter (Register 84, No. 28). 
§ 90421 . Incomplete Application. 

NOTE: Authority cited: Sections 437.6, 438. 1 , 438.2, and 438.4, Health and Safety 
Code; and Sections 21089 and 21 100, Public Resources Code. Reference: Sec- 
tions 438.1 and 438.2, Health and Safety Code; and Sections 21082, 21089 and 
21 100, Public Resources Code. 

History 

1. Amendment of subsections (c) and (d) filed 9-8-77; effective thirtieth day 
thereafter (Register 77, No. 37). 

2. Amendment filed 4-1 1-80; effective thirtieth day thereafter (Register 80, No. 
15). 

3. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90422. Projects for Sole Community Providers or Long 
Term Care. 

(a) For puiposes of this section and Health and Safety Code Section 
437.15 a sole community provider is any general acute care hospital eli- 
gible to be designated as a primary health service hospital pursuant to 
Health and Safety Code Section 1339.9. 

(b) An application eligible for consideration under Health and Safety 
Code Section 437.15 shall be filed on the forms specified by the Office 
for such projects. 

(c) Upon receipt of an application on forms specified by the Office, the 
Division shall evaluate the application to determine whether the project 
is for a sole community provider or long term care. 

(d) If the Division determines that the project is for a sole community 
provider or long term care the Division shall publish the notice required 
by paragraph 2 of subdivision (c) of Health and Safety Code Section 
437.15. 

(e) If the Division determines that the project is not for a sole commu- 
nity provider or long term care the Division shall so notify the applicant 
and shall treat the application as a notice of intent pursuant to Health and 
Safety Code Section 438.3. 

NOTE: Authority cited: Sections 437.6, 437.15 and 438, Health and Safety Code. 
Reference: Sections 437.15 and 438.3, Health and Safety Code. 

History 
1. New section filed 2-28-85: effective thirtieth day thereafter (Register 85, No. 
9). 

§ 90423. Complete Application. 

The application shall be considered to be filed as a complete applica- 
tion on the date the notice of completeness is sent to the applicant or the 
sixteenth day following the Office's receipt of the application, whichever 
is earlier, or, when the applicant has made a request pursuant to Health 
and Safety Code Section 438.2(b), on the fifth business day following re- 
ceipt by the Office of the request, unless the Office makes a timely deter- 
mination that the application may not be declared complete. 
Note; Authority cited: Sections 437.6 and 438.2, Health and Safety Code. Refer- 
ence: Sections 438.2 and 438.5, Health and Safety Code. 

History 

1. Amendment of subsection (a) filed 9-8-77: effective thirtieth day thereafter 
(Register 77, No. 37). 

2. Amendment filed 5-17-83; designated effective 4-22-83 pursuant to Govern- 
ment Code Section 1 1349.3 (Register 83, No. 21). 



3. Amendment of NOTE filed 10-14-83: designated effecfive 10-17-83 pursuant 
to Government Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90425. Verification of Certified Cost Estimates. 

History 
1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90427. Public Inspection. 

History 
1 . Repealer filed 10-14-83: desisnaied effective 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1346.2(d)''(Register 83, No. 42). 

§ 90429. Amendments to Applications. 

(a) Amendments to an application shall be submitted in writing to the 
Office and the appropriate area agency. 

(b) An application with amendments shall be treated as a new applica- 
tion, unless: 

(1) The amendments do not materially affect the scope, location, or 
cost of the proposed project, or change the identity of the proposed li- 
censee; and 

(2) Extensive additional analysis of the application is not necessitated 
by the amendments. 

(c) The applicant may be required to pay additional fees as determined 
by the office. 

NOTE; Authority cited: Sections 437.6, 438, 438.1 and 438.2, Health and Safety 
Code. Reference: Section 438, Health and Safety Code. 

History 

1. Amendment of subsections (a) and (c) filed 9-8-77; effective thirtieth day 
thereafter (Register 77, No. 37). 

2. Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90431 . Withdrawal of Applications. 

History 
1 . Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90433. Area Agency Review. 

NOTE: Authority cited: Sections 437.6, 437.7, 437.8, 437.15 and 438.4, Health 
and Safety Code. Reference: Sections 437.7 and 438.4, Health and Safety Code. 

History 

1. Amendment of subsecfion (b) filed 12-8-76 as an emergency; effective upon 
filing (Register 76, No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 1 1). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 
37). 

4. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Secfion 1 1346.2(d) (Register 83. No. 42). 

5. Repealer filed 7-1 1-84; effecfive thirtieth day thereafter (Register 84, No. 28). 



Article 6. Hearing Procedure on 
Applications for a Certificate of Need 

§ 90501. Time and Place of Hearing. 

History 
1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1346.2(d) (Register 83, No. 42). 

§ 90503. Notice of Hearing. 

History 
1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90504. Informal Hearings. 

(a) A request for an informal hearing, in lieu of and in the alternative 
to the formal procedures described in Health and Safety Code Section 
438.5, shall be made in writing and addressed to the Division of Health 
Planning and Review, Fourth Floor, 1600 Ninth Street, Sacramento, CA 
95814. 

(b) The request shall be made after the Office has ordered a hearing 
pursuant to Health and Safety Code Section 438.5 and shall be made prior 
to commencement of the formal hearing. 



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Title 22 



Health Planning and Facility Construction 



§ 90509 



(c) The request may be deli vered prior to issuance of an order for a for- 
mal hearing by the Office. If so, the request shall be deemed to have been 
received, for purposes of the five day period within which the Office must 
order an informal hearing, on the earlier of: 

( 1 ) the last day the Office is allowed to issue an order for a formal hear- 
ing; or 

(2) the date the Office issues the order for the informal hearing. 

NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
tion 438.51, Health and Safety Code. 

History 
1 . New section filed 2-28-85; effective thirtieth day thereafter (Register 85, No. 
9). 

§ 90505. Service of Papers. 

History 
1. Amendment of subsection (b) filed 9-8-77; effective thirtieth day thereafter 
(Register 77, No. 37). 



2. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1 346.2(d) (Register 83, No. 42). 

§ 90507. Parties. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d)''(Register 83, No. 42). 

§ 90509. Obligations of the Parties Prior to the Hearing. 

(a) In preparing the intended position, the Division shall take into ac- 
count any significant environmental effects identified in a final EIR on 



[The next page is 1199.] 



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Title 22 



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§ 90559 



the project, if available, and shall, whenever appropriate, consider feasi- 
ble alterations in the project to mitigate or avoid the significant environ- 
mental effects. The Division shall, if necessary, revise an intended posi- 
tion to account for information in a final EIR or negative declaration 
submitted after preparation of the initial intended position. 

(b) At least 15 days prior to the hearing each party shall serve upon 
each of the other parties and upon the hearing officer a list of witnesses 
intended to be presented together with estimated time for direct examina- 
tion of each witness. The list shall include the name, address, and title of 
each intended witness. 

NOTE: Authority cited: Sections 437.6 and 438.5, Health and Safety Code; and 
Sections 21000(g), 21081 and 21 100, Public Resources Code. Reference: Section 
438.5, Health and Safety Code; and Section 21081, Public Resources Code. 

History 

1. Amendment of subsection (b) filed 9-8-77; effective thirtieth day thereafter 
(Register 77, No. 37). 

2. Amendment filed 4-1 1-80; effective thirtieth day thereafter (Register 80, No. 
15). 

3. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

4. Amendment filed 2-28-85; effective thirtieth day thereafter (Register 85, No. 
9)- 

§ 9051 1 . Requests for Depositions. 

History 

1. Amendment of subsection (a) filed 9-8-77; effective thirtieth day thereafter 
(Register 77, No. 37). 

2. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Secfion 11346.2(d) (Register 83, No. 42). 

§ 90512. Witnesses and Subpoenas. 

NOTE: Authority cited: Sections 208, 437.7-437.11, 437.13, 438.5, 438.6, 1203 
and 1 255, Health and Safety Code; Chapter 854 (Statutes of 1976). Reference: AB 
4001, Chapter 854, Statutes of 1976. 

History 

1. New section filed 12-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 1 1). 

3. Amendment of subsecdons (d) and (e) filed 9-8-77; effective thirtieth day 
thereafter (Register 77, No. 37). 

4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1 346.2(d) (Register 83, No. 42). 

§90513. Hearing Procedure. 

Note: Authority cited: Secrions 437.6, and 438.5, Health and Safety Code. Refer- 
ence: Section 438.5, Health and Safety Code. 

History 

1. Amendment of subsecfion (b) filed 9-8-77; effecfive thirtieth day thereafter 
(Register 77, No. 37). 

2. Amendment filed 4-1 1-80; effective thirtieth day thereafter (Register 80, No. 
15). 

3. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90515. Basis for Decisions on Projects. 

(a) The basis for decisions by the Office on applications for Certifi- 
cates of Need shall be: 

(1) The Statewide Health Facilities and Services Plan specified in 
Health and Safety Code Section 437.7, Subdivision (b). 

(2) The Statewide Policies developed and adopted pursuant to Health 
and Safety Code Section 437.8, including the review criteria established 
in Article 11. 

(b) In deciding upon a project for which an environmental impact re- 
port has been prepared, the Office shall consider and make written find- 
ings with respect to that report. 

(1) If the report identifies one or more significant environmental ef- 
fects of the project, the Office shall not approve the project unless the Of- 
fice makes one or more of the following written findings, accompanied 
by a statement of facts supporting each finding: 

(A) Changes or alterations which mitigate or avoid the significant en- 
vironmental effects of the project identified in the final EIR have been 
required or incorporated into the project. 



(B) Changes or alterations which would mitigate or avoid the signifi- 
cant environmental effects of the project identified in the final EIR are 
within the responsibility and jurisdiction of another public agency and 
not of the Office. Such changes have been adopted by such other agency 
or can and should be adopted by such other agency. 

(C) Specific economic, social, or other considerations make infeasible 
the mitigation measures or project alternatives identified in the final EIR. 

(2) The findings required by (1 ) shall be supported by substantial evi- 
dence in the record. 

(3) The finding described in (1)(B) shall not be made if the Office has 
concurrent jurisdiction with another agency to deal with identified feasi- 
ble mitigation measures or alternatives. 

Note: Authority cited: Sections 437.6, 437.9 and 438.5, Health and Safety Code; 
and Sections 21000, 21001, 21002.1 and 21082, Public Resources Code. Refer- 
ence: Section 438.5, Health and Safety Code. 

History 

1. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 
37). 

2. Editorial correction removing subsections (b) and (c), and correcting previous 
history note (Register 78, No. 24). 

3. New subsection (b) filed 4-1 1-80; effective thirtieth day thereafter (Register 
80, No. 15). 

4. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 11346.2(d) (Register 83, No. 42). 

§90517. Decisions. 

History 

1. Amendment filed 9-8-77; effecfive thirtieth day thereafter (Register 77, No. 

37). 

2. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 1 1 346.2(d) (Register 83, No. 42). 



Article 7. Appeals 

§90551. Appeals. 

(a) The operation of the administrative appeals process for certificate 
of need applications established b Health and Safety Code Sections 438.8 
to 438.12, inclusive, and implemented by this Article is suspended. 

(b) No petition for appeal shall be accepted by the Council after the ef- 
fective date of this regulation. 

(c) Any appeal pending as of the date this suspension becomes effec- 
tive shall be processed in accordance with Article 7 as it stood immedi- 
ately before that date. 

NOTE: Authority cited: Secfion 437.6, Health and Safety Code. Reference: Sec- 
fion 437.6, Health and Safety Code. 

History 

1. Repealer and new section filed 5-17-83; designated effective 4-22-83 pursuant 
to Government Code Section 1 1349.3 (Register 83, No. 21). 

2. Amendment of NOTE filed 10-14-83; designated effective 1 0-1 7-83 pursuant 
to Government Code Section 1 1346.2(d) (Register 83, No. 42). 

3. Amendment of subsecfion (a) filed 2-28-85; effective thirtieth day thereafter 
(Register 85, No. 9). 

§ 90553. Appeal Filing Procedures. 

History 

1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90555. Service of Papers. 

History 

1. Repealer filed 10-14083; designated effecfive 10-17-83, pursuant to Govern- 
ment Code Secfion 11346.2(d) (Register 83, No. 42). 

§ 90557. Certification of Oral Arguments. 

History 

1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90559. Notice of Hearing. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1346.2(d) (Register 83, No. 42). 



Page 1199 



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Title 22 



§ 90561 . Appeal Hearing Procedure. 

History 
1. Repealer filed 10-14-83; desienated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d)'(Registei- 83. No. 42). 

§ 90563. Notice of Meeting. 

History 
1. Repealer filed 10-14-83: designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d)'(Register 83, No. 42). 

§ 90565. Decisions on Appeal. 

History 

1. Repealer 10-14-83; designated effective 10-17-83 pursuant to Government 
Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90567. Disqualification. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(dHRegister 83, No. 42). 



3. Repealer filed 7-1 1-84; effective thiitieth day thereafter (Register 84, No. 2^ 



Article 8. Certificate of Exemption 

§ 90601 . Types of Exempt Projects. 

History 

1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1346.2(d) (Register 83, No. 42). 

§ 90603. Projects Not Subject to Review by a Voluntary 
Area Health Planning Agency. 

History 
1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1 346.2(ii) (Register 83, No. 42). 

§ 90605. Projects Previously Decided by a Voluntary Area 
Health Planning Agency. 

History 

1. Amendment of subsections (a) and (c) filed 9-8-77; effective thirtieth day 
thereafter (Register 77, No. 37). 

2. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90607. Exemption Requests for Remodeling and 
Replacement Projects. 

NOTE; Authority cited: Sections 437.6, 437.13 and 437.14, Health and Safety 
Code. Reference: Sections 437.13 and 437.14, Health and Safety Code. 

History 

1 . Amendment of subsection (f)(4) filed 12-8-76 as an emergency; effective upon 
filing (Register 76, No. 50). 

2. Certificate of Comphance filed 3-8-77 (Register 77, No. 11). 

3. Amendment of subsection (a) filed 9-8-77; effective thirtieth day thereafter 
(Register 77, No. 37). 

4. Amendment filed 3-1-78; effective thirtieth day thereafter (Register 78, No. 9). 

5. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

6. Repealer filed 7-1 1-84; effecfive thirtieth day thereafter (Register 84, No. 28). 
§ 90608. Facility Serving an Underserved Population. 

NOTE: Authoiity cited: Secfions 208, 437.10, 437.13, and 437.14, Health and 
Safety Code. Reference: Sections 437. lOA, 437.13 and 437.14, Health and Safety 
Code; and Chapter 854, Statutes of 1976. 

History 

1 . New section filed 3-1-78; effecfive thirtieth day thereafter (Register 78, No. 9). 

2. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90609. Delineation of Services and Departments Within 
Health Facilities. 

NOTE: Authority cited: Sections 437.6 and 437.13, Health and Safety Code. Ref- 
erence: Secfion 437.13, Health and Safety Code. 

History 

1 . New section filed 3-1-78; effecfive thirtieth day thereafter (Register 78, No. 9). 

2. Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Section 1 1 346.2(d) (Register 83, No. 42). 



Article 9. Terms and Conditions 

§ 90701 . Notice of Decision. 

History 

1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90703. Effective Date of Final Decisions. 

History 

1. Amendment of subsecfions (a), (e) and new subsection (f) filed 9-8-77; effec- 
tive thirtieth day thereafter (Register 77, No. 37). 

2. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90704. Transferability of Certificates. 

(a) A certificate of need or certificate of exemption is particular to one 
specific existing or proposed facility and is not transferable or assignable 
to another facility. 

(b) A certificate of need or certificate of exemption pertaining to a 
project for an existing facility is not invalidated by transfer of ownership 
of that facility. 

(c) A certificate of need for establishment of a new facility may not be 
transferred to a person other than the applicant. 

NOTE: Authority cited: Section 437.6, Health and Safety Code. Reference: Sec- 
fions 437.10 and 437.8, Health and Safety Code. 

History 
1. New secfion filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90705. Expiration of Certificates. 

(a) A certificate of need or a certificate of exemption shall expire 18 
months after the effective date unless one of the following occurs: 

(1) The certificate holder has commenced the project covered by the 
certificate and is diligently pursuing the project to completion as deter- 
mined by the Office. 

(A) Commencement of the project for purposes of this subsection shall 
mean that the applicant has executed a written contract for completion of 
the project or has submitted to the Office preliminary drawings and out- 
line specifications which fully comply with applicable requirements of 
Title 24. 

(B) Diligently pursuing the project to completion for purposes of this 
section means that the project is progressing toward completion accord- 
ing to a reasonable time schedule and, where applicable, that construc- 
tion of the project has commenced in accordance with the schedule sub- 
mitted in the application for the certificate. 

(2) The expiration date of the certificate has been extended by the Di- 
rector upon a showing of good cause in accordance with Subsection (c). 
Extension shall not cumulatively exceed a total of 12 months beyond the 
original expiration date of the certificate. 

(b) A certificate of exemption issued under Health and Safety Code 
Section 437. 11 7 shall expire 12 months after issuance unless the project 
has been completed or the expiration date has been extended in accor- 
dance with subdivision (c). For purposes of this subdivision, completion 
of the project shall be the date the Department of Health Services ap- 
proves the equipment or space for use. In order for the project to be deter- 
mined complete for the purposes of this section, the facility must submit 
evidence of completeness to the Office of Statewide Health Planning and 
Development. 

(c) The Director may extend the time for commencement or comple- 
tion of a project if the holder of the certificate satisfies the Director that 
the delay is the result of an unpreventable or unexpected occurrence such 
as an emergency, strike, disaster, unforeseen shortage of materials, re- 
quired governmental agency review or other such unforeseen event. 

(d) Applicants requesting extensions under this section shall submit a 
request at least 30 days prior to the expiration date of the certificate. 



• 



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Title 22 



Health Planning and Facility Construction 



§ 90813 



(e) Before making a final determination that a certificate of need or a 
certificate of exemption has expired, the Office shall afford an opportuni- 
ty for a hearing to any applicant whose certificate of need or certificate 
of exemption appears to have expired. 

NOTE; Authority cited: Sections 437.6 and 438.6, Health and Safety Code; and 
Section 11 180, Govemment Code. Reference: Section 438.6. Health and Safety 
Code. 

History 

1. Amendment of subsection (a) filed 9-8-77; effective thirtieth day thereafter 
(Register 77, No. 37). 

2. Amendment filed 3-1-78; effective thirtieth day thereafter (Register 78, No. 9). 

3. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 1 1 346.2(d) (Register 83, No. 42). 

4. Amendment filed 2-28-85; effective thirtieth day thereafter (Register 85. No. 
9). 

§ 90705.1. Extensions Necessitated by Uncertainty of 
Government Revenue Source. 

NOTE: Authority cited: Sections 208, 438.6 and 437.14, Health and Safety Code. 
Reference: Sections 438.6 and 437.14, Health and Safety Code. 

History 

1. New section filed 8-2-78 as an emergency; effective upon filing (Register 78, 
No. 31). 

2. Certificate of Compliance filed 1 1-29-78 (Register 78, No. 48). 

3. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govem- 
ment Code Secfion 1 1346.2(d) (Register 83, No. 42). 

§ 90707. Revocation of Certificates. 

History 
1. Repealer filed 10-14—83; designated effective 10-17-83 pursuant to Govem- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 



Article 10. Development of Plans 

§90801. Area Plans. 

(a) Each area agency shall develop an area plan in accordance with the 
requirements of this chapter and such other statewide procedures, speci- 
fications, and format as my be established by the Office. 

(b) An area plan shall be for the entire health planning area served by 
the agency. 

(c) Each area agency shall establish resource requirements, consistent 
with statewide policies, and the Plan Development Guidelines which 
have been incorporated by reference into these regulations by Section 
90304. 

(d) In using data and methods in accordance with the Plan Develop- 
ment Guidelines, incorporated by reference into these regulations by 
Section 90304, area agencies shall consider but are not limited to the fol- 
lowing: 

(1) Current and projected civilian population of the service area. 

(2) Utilization of existing facility health resources. 

(3) Appropriate utilization levels of facility health resources. 

(4) Optimal capacity of facility health resources. 

(5) The service area for the specified types of facility health resources. 

(e) In developing the area plan, the area agency shall utilize the data 
and methods provided by the Office. The area agency may review such 
data and methods in public meeting and may propose alternate data 
sources that are more responsive to the needs of the health planning area 
and may use such data sources with the approval of the Office. 

(f) The area agency may propose alternate methods, consistent with 
cost effective utilization of health facilities, if the area agency determines 
with the concurrence of the office that the alternative methods will be 
more responsive to the needs of the health planning area. 

(g) Area plans shall identify and quantify existing resources and com- 
munity needs for each bed classification and project type required by the 
Office to be addressed. 

NOTE: Authority cited: Sections 437.6, 437.7 and 437.8, Health and Safety Code. 
Reference: Sections 437.7 and 437.8, Health and Safety Code. 



History 

1. Amendment filed 9-8-77; effective thirtieth dav thereafter (Register 77, No. 

37). 

2. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
emment Code Section 11 346.2(d) (Register 83, No. 42). 

§ 90803. Data and Methods of Area Plans. 

History 

1. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

2. Repealer filed 10-14-83: designated effective 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90807. General Requirements for Recommended 

Actions. 

NOTE; Authority cited: Sections 437.6, 437.7 and 437.8, Health and Safety Code. 
Reference: Secfions 437.7 and 437.8, Health and Safety Code. 

History 

1. New section filed 6-14-78; effective thirtieth day thereafter (Register 78, No. 

24). 

2. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secnon 11346.2(d) (Register 83, No. 42). 

§ 90809. Area Agency Alternative Methods and Rates. 

NOTE: Authority cited: Secfions 208 and 437.8, Health and Safety Code. Refer- 
ence: Chapter 854, Statutes of 1976 as amended by Chapter 429, Statutes of 1978 
and Chapter 1 186, Statutes of 1979. 

History 

1. New section filed 6-14-78; effective thirtieth day thereafter (Register 78, No. 
24). 

2. Repealer filed 5-22-80; effective thirtieth day thereafter (Register 80, No. 21 ). 

§ 9081 1 . Health Facility Planning Areas. 

(a) The Office shall designate health facility planning areas to be used 
by area agencies for the planning and review of facilities, services, and 
equipment. 

(b) In designating health facility planning areas, the Office shall con- 
sider at least the following factors: 

(I) Size and distribution of resident and transient population and de- 
mographic characteristics. 

(•2) Population base required to support specified types of facility 
health resources. 

(3) Natural geographic boundaries. 

(4) Governmental jurisdictions. 

(5) Transportation routes and travel time. 

(6) Trade patterns. 

(7) Number and distribution of major providers. 

(8) Customary health service delivery patterns. 

(9) Location of existing facilities and services. 

(10) Climatic conditions that affect the use of health resources. 

(II) Patterns of patient origin. 

(c) Health facility planning areas shall, to the extent possible, not di- 
vide county boundaries, individual health planning areas, or census 
tracts. 

(d) Health facility planning areas should encompass the largest popu- 
lation base possible to assure economic feasibility and quality of care. 

(e) Changes in health facility planning areas may be proposed to the 
Office by area agencies at any time; however, the Office shall consider 
such proposals on an annual basis with the advice of the Council. 

NOTE: Authority cited: Sections 437.6, 437.7 and 437.8, Health and Safety Code. 
Reference: Secfions 437.7 and 437.8, Health and Safety Code. 

History 

1. Amendment of subsecfion (d) filed 9-8-77; effective thirtieth day thereafter 
(Register 77, No. 37). 

2. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
emment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90813. Inventory and Utilization Data of Health 
Resources. 

History 

1. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govem- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 



Page 1201 



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§ 90815 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



§ 90815. Population to Be Used in Area Planning. 

(a) The Office shall annually prepare population estimates and projec- 
tions to be used in area plans. 

(b) Population estimates and projections prepared by the Office for 
counties shall be based on estimates provided by the California Depart- 
ment of Finance. 

NOTE: Authority cited: Sections 437.6, 437.7 and 437.8, Health and Safety Code. 
Reference: Sections 437.7 and 437.8. Health and Safety Code. 

History 

1. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 
37). 

2. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(dHRegister 83, No. 42). 



§ 90819. Statewide Health Facilities and Services Plan. 

History 

1. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 



§ 90821 . Procedures for Adoption of Area Plans. 

(a) Each area agency shall conduct at least one public meeting on its 
proposed area plan prior to its adoption, interested parties shall be given 
the opportunity to submit their views orally at the meeting and in writing 
before or during the meeting. 

(b) At least 30 days before the meeting the agency shall publish a no- 
tice of the hearing in at least two newspapers of general circulation 
throughout the health planning area. The notice shall: 

(1) Identify the time and place of the meeting and the availability and 
location of the proposed plan for public review. 

(2) Be expressed in the predominant languages used in the health plan- 
ning area, using words of plain meaning. Predominant languages shall be 
English and any other language used as a primary language by three per- 
cent or more of the population in the health planning area if a newspaper 
of general circulation is available which will reach persons with such pre- 
dominant languages. 

(c) The governing body of the area agency shall adopt the area plan in 
a public meeting. Notice shall conform to all of the criteria contained in 
(b) above. 

(d) Each area agency shall forward to the Office of Statewide Health 
Planning and Development a copy of the minutes of the meeting at which 
the area plan was adopted and five copies of the plan. One copy of the 
plan shall be forwarded to the Advisory Health Council. 

Note: Authority cited: Sections 437.6, 437.7 and 437.8, Health and Safety Code. 
Reference: Sections 437.7 and 437.8, Health and Safety Code. 

History 

1. New section filed 6-14-78; effective thirtieth day thereafter (Register 78, No. 
24). 

2. Amendment of subsection (d) filed 1-1 1-82; effective thirtieth day thereafter 
(Register 82, No. 3). 

3. Amendment filed 10-14-83; designated effecfive 10-17-83 pursuant to Gov- 
ernment Code Secdon 1 1346.2(d) (Register 83, No. 42). 



§ 90823. Adoption of Statewide Health Facilities and 
Services Plan. 

NOTE: Authority cited: Section 437.7(b), Health and Safety Code. Reference: AB 
4001, Chapter 854, Statutes of 1976. 

History 

1. New section filed 3-23-79; effective 3-21-79 pursuant to Section 437.7(b), 
Health and Safety Code, and Section 1 1422(a), Government Code (Register 79, 

No. 13). 

2. Amendment filed 4^4-80; designated effecfive 3-28-80 pursuant to Secfion 
437.7(b), Health and Safety Code, and Secfion 1 1422(a), Government Code 
(Register 80, No. 14). 

3. Repealer filed 10-14-83; designated effecfive 10-17-83 pursuant to Govern- 
ment Code Section 1 1 346.2(d) (Register 83, No. 42). 



Article 11. Review Criteria 

§ 90901 . Criteria for Determining the Desirability of 
Projects. 

(a) Except as otherwise provided in Health and Safety Code Section 
437. 1 2, the Office shall not issue a certificate of need for any project un- 
less the project is found to be desirable in accordance with this section 
and, for a surgical clinic, Section 90927. 

(b) Except as otherwise provided in Health and Safety Code Section 
437. 12, no project shall be found to be desirable unless the applicant esta- 
blishes by a preponderance of the evidence that the project meets all of 
the following: 

( 1 ) The project will fill an unmet community need identified in the Sta- 
tewide Health Facilities and Services Plan, if the type of project is ad- 
dressed in the Plan. 

(2) The project will not have a substantial adverse effect on the utihza- 
tion of other facilities offering the same or similar services or such ad- 
verse effect is outweighed by the benefits of the project to the population 
to be served. 

(3) The project will be optimally utilized within a reasonable time peri- 
od in a financially feasible and economically efficient manner. 

(4) Financial resources exist to successfully complete and implement 
the project. 

(5) The project and the facihty comply with applicable federal, state, 
and local laws and regulations. 

(6) Tlie applicant is capable of completing and implementing the proj- 
ect. 

(7) As applicable there is community support for the facility and the 
project. 

(8) The project will, as applicable, enhance accessibility of health ser- 
vices to the population to be served. 

(9) The project will benefit the population to be served. 

(10) The project will not adversely affect the indigent population of the 

area. 

NOTE: Authority cited: Sections 437.6, 437.8 and 437.9, Health and Safety Code. 
Reference: Sections 437.8 and 437.9, Health and Safety Code. 

History 

1 . Amendment of subsections (a), (b) and (d) filed 9-8-77; effective thirtieth day 
thereafter (Register 77, No. 37). 

2. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Secfion 1 1346.2(d) (Register 83, No. 42). 

3. Amendment filed 2-28-85; effecfive thirtieth day thereafter (Register 85, No. 
9). 

§ 90902. Criteria for Projects Not Directly Related to 
Patient Care. 

NOTE: Authority cited: Sections 437 .6, 437 .8, 437 .9 and 437 . 1 5, Health and Safe- 
ty Code. Reference: Sections 437.8, 437.9 and 437.15, Health and Safety Code, 

History 

1. New section filed 5-17-83; designated effective 4-22-83 pursuant to Govern- 
ment Code Section 1 1349.3 (Register 83, No. 21 ). For history of former section, 
see Registers 77, No. 37; 77, No. 1 1 and 76, No. 50. 

2. Amendment of NOTE filed 10-14-83; designated effective 10-17-83 pursuant 
to Government Code Section 11346.2(d) (Register 83, No. 42). 

3. Repealer filed 7-1 1-84; effective thirtieth day thereafter (Register 84, No. 28). 

§ 90903. Criteria for Comprehensive Group Practice 
Prepayment Health Care Service Plans. 

History 

1 . Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No, 
37). 

2. Editorial correction of printing error (Register 83, No. 30). 

3. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1346.2(d) (Register 83, No. 42). 

§ 90904. Criteria for Equipment Replacement Projects Not 
Exempt Under Section 90607 Solely Because 
of Section 90607(c)(6). 

NOTE: Authority cited: Sections 437.6, 437.8 and 437.9, Health and Safety Code. 
Reference: Sections 437.8 and 437.9, Health and Safety Code. 



• 



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Health Planning and Facility Construction 



§ 90921 



History 

1 . New section filed 4-26-79; effective thirtieth day thereafter (Register 79, No. 
17). 

2. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 

3. Repealer filed 7-1 1-84; effective thirtieth day thereafter (Register 84, No. 28). 

§ 90905. Criteria for Projects for Which Special 
Justification is Claimed. 

History 

1. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

2. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90906. Review of Competing Applications. 

(a) When concurrently considering similar applications for certifi- 
cates of need to serve substantially the same geographic area and popula- 
tion, the Office shall approve only the application or applications which 
most appropriately meet the needs of the area and population to be 
served. The Office may approve or disapprove all applications under 
consideration. 

(b) The Office shall seek the cooperation of the applicants in reviewing 
and making determinations with respect to competing applications. The 
Office shall not unreasonably delay action on an application for a certifi- 
cate of need and shall meet requirements of time imposed by statute and 
regulations unless parties to all affected applications have filed written 
waivers of time requirements in order to permit concurrent reviews and 
decisions. If an applicant refuses to waive time hmitations, the testimony 
of any competing applicants shall be taken at the hearing. 

(c) In determining which application or applications most appropriate- 
ly meet the needs of the area and population to be served, the Office shall 
consider all relevant factors, including but not limited to the following: 

(1) Location. 

(2) Travel time and transportation costs. 

(3) Medical feasibility of utilizing the proposed facilities or services 
or facility beds, taking into consideration the medical condition of the pa- 
tients proposed to be served and other relevant information. 

(4) Current utilization patterns. 

(5) All applicable review criteria. 

NOTE: Authority cited: Sections 437.6, 437.7, 437.8 and 437.9, Health and Safety 
Code. Reference: Sections 437.7, 437.8 and 437.9, Health and Safety Code. 

History 

1. New section filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 
37). 

2. Amendment filed 10-14-83; designated effective thirtieth day thereafter (Reg- 
ister 83, No. 42). 

§ 90907. Criteria for a Burn Center. 

NOTE: Authority cited: Sections 208. 437.7-437.1 1, 437.13, 438.5, 438.6, 1203 
and 1255, Health and Safety Code; Chapter 854 (Statutes of 1976). Reference: AB 
4001, Chapter 854, Statutes of 1976. 

History 

1 . New section filed 12-8-76 as an emergency; effective upon fding (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90909. Criteria for Cardiovascular Surgery Service. 

NOTE: Authority cited: Sections 208, 437.7-437.1 1, 437.13, 438.5, 438.6, 1203 
and 1255, Health and Safety Code; Chapter 854 (Statutes of 1976). Reference: AB 
4001, Chapter 854, Statutes of 1976. 

History 

1. New section filed 12-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 
37). 



4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§ 9091 1 . Criteria for Chronic Dialysis Stations. 

NOTE: Authority cited: Sections 208 and 437.8, Health and Safety Code; Chapter 
854 (Statutes of 1976). Reference: 437.10(b) and (c), Health iuid Safety Code. 

History 

1 . New section filed 12-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 
37). 

4. Amendment of subsection (a) filed 1 1-18-77; effective thirtieth day thereafter 
(Register 77, No. 47). 

5. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(dHRegister 83, No. 42). 

§ 90913. Criteria for a Computerized Tomography (CT) 
Scanner. 

NOTE: Authority cited: Sections 208, 437.7-437.1 1, 437.13, 438.5, 438.6, 1203 
and 1255, Health and Safety Code; Chapter 854 (Statutes of 1 976). Reference: AB 
4001, Chapter 854, Statutes of 1976. 

History 

1. New section filed 12-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 
37). 

4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90915. Criteria for Emergency Medical Service, Basic. 

NOTE: Authority cited: Sections 208, 437.7-437.11, 437.13, 438.5, 438.6, 1203 
and 1255, Health and Safety Code; Chapter 854 (Statutes of 1976). Reference: AB 
4001, Chapter 854, Statutes of 1976. 

History 

1 . New section filed 12-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 1 1). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90917. Criteria for Emergency Medical Service, 
Comprehensive. 

NOTE: Authority cited: Sections 208, 437.7-437.11, 437.13, 438.5, 438.6, 1203 
and 1 255, Health and Safety Code; Chapter 854 (Statutes of 1 976). Reference: AB 
4001, Chapter 854, Statutes of 1976. 

History 

1 . New section filed 1 2-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 1 1). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 
37). 

4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1346.2(d) (Register 83, No. 42). 

§ 90919. Criteria for Intensive Care Newborn Nursery 
Service. 

NOTE: Authority cited: Sections 208, 437.7-437.1 1, 437.13, 438.5, 438.6, 1203 
and 1255, Health and Safety Code; Chapter 854 (Statutes of 1976). Reference: AB 
4001, Chapter 854, Statutes of 1976. 

History 

1 . New section filed 12-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 1 1). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 11346.2(d) (Register 83, No. 42). 

§ 90921 . Criteria for Psychiatric Service. 

Note: Authority cited: Sections 208, 437.7-437.1 1, 437.13, 438.5. 438.6, 1203 
and 1255, Health and Safety Code; Chapter 854 (Statutes of 1976). Reference: AB 
4001, Chapter 854, Statutes of 1976. 



Page 1203 



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BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



History 

1 . New section filed 12-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 1 1). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

4. Repealer filed 10-14-83; desienated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1 346.2(d)''(Register 83, No. 42). 

§ 90923. Criteria for Radiation Therapy Service. 

NOTE: Authority cited: Sections 208, 437.7-437.1 1, 437.13, 438.5, 438.6, 1203 
and 1255, Health and Safety Code; Chapter 854 (Statutes of 1976). Reference: AB 
4001, Chapter 854, Statutes of 1976. 

HlSTOi^Y 

1 . New section filed 1 2-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 1 1). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90925. Criteria for Renal Transplant Service. 

NOTE: Authority cited: Sections 208, 437.7-437.11, 437.13, 438.5, 438.6, 1203 
and 1255, Health and Safety Code; Chapter 854 (Statutes of 1976). Reference: AB 
4001, Chapter 854, Statutes of 1976. 

History 

1 . New section filed 12-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 

37). 

4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1346.2(d) (Register 83, No. 42). 

§ 90927. Criteria for Surgical Clinics. 

(a) An applicant for a new surgical clinic shall establish by a prepon- 
derance of evidence that: 

(1) The surgical clinic will have at least two operating rooms. 

(2) The surgical clinic, as a condition of granting staff privileges, will 
require the physicians to maintain comparable clinical privileges in local 
general acute care hospitals. 

(3) The applicant has an appropriate utilization review plan and quality 
assurance plan. 

(4) The applicant has acceptable written procedures for the transfer of 
surgical clinic patients and their records in an emergency to an appropri- 
ate general acute care hospital in the service area. 

(5) The surgical clinic can achieve and maintain a minimum of 240 op- 
erating room minutes (not including preparation and clean up time) per 
operating room per day within three years of commencement and will not 
cause the utilization at existing surgical clinics to drop below or fail to 
attain the minimum of 240 operating room minutes per operating room 
per day. For purposes of this section, surgical operating room minutes 
shall be calculated on the basis of five days per week and fifty weeks per 
year. 

(6) There will be a sufficient number of physicians in the service area 
who will use the surgical clinic and will have staff privileges and will en- 
able the cUnic to meet the minimum operating room time. 

(7) It will be an appropriate facility in the service area, considering 
equipment, staff, location, and other relevant factors. 

(8) The cHnic will make provision to serve those who are unable to pay 
all or a substantial portion of the clinic's fee in advance of the provision 
of services. 

(b) Notwithstanding Section 90901(b)(1), with respect to the determi- 
nation of unmet need in the community, and notwithstanding Section 
90901(b)(2), with respect to the determination of adverse effect, the 
applicant may demonstrate that area hospitals are not making efforts to 
fully utilize their ambulatory surgical capacity or providing ambulatory 
surgical services at a reasonable cost to the community. With respect to 
the determination of unmet community need for purposes of Section 



90901 (b)(l ), and with respect to the determination of adverse effect un- 
der Section 90901(b)(2), the Office shall not consider any hospital in the 
service area which the apphcant demonstrates does not meet both of the 
following criteria: 

(1) The hospital has a functioning, organized ambulatory surgery pro- 
grain with staff, approved policies, procedures, quality of care standards, 
and other documentation associated with an organized ambulatory sur- 
gery program. 

(2) The hospital is making good faith efforts to utilize its ambulatory 
surgical capacity and to provide ambulatory surgical services at a reason- 
able cost to the community. 

NOTE: Authority cited: Secfions 437.6, 437.7, 437.8 and 437.9. Health and Safety 
Code. Reference: Sections 437.7, 437.8 and 437.9, Health and Safety Code. 

History 

1 . New section filed 1 2-8-76 as an emergency; effective upon filing (Reeister 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 
37). 

4. Repealerand new section filed 5-17-83; designated effective 4-22-83 pursuant 
to Government Code Secfion 1 1349.3 (Register 83, No. 21). 

5. Repealer and new section filed 10-14-83; designated effecfive 10-17-83 pur- 
suant to Government Code Section 11346.2(d) (Register 83, No. 42). 

§ 90929. Criteria for a Basic, Supplemental, Required or 
Optional Service. 

NOTE: Authority cited: Sections 208, 437.7-437.1 1, 437.13, 438.5, 438.6, 1203 
and 1255, Health and Safety Code; Chapter 854 (Statutes of 1976). Reference: AB 
4001. Chapter 854, Statutes of 1976. 

History 

1 . New secfion filed 1 2-8-76 as an emergency; effective upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 11). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 
37). 

4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Secfion 1 1346.2(d)''(Register 83, No. 42). 

§ 90931 . Criteria for a Capital Expenditure. 

NOTE: Authority cited: Secfions 208, 437.7-437.11, 437.13, 438.5, 438.6, 1203 
and 1255, Health and Safety Code; Chapter 854 (Statutes of 1976). Reference: AB 
4001, Chapter 854, Statutes of 1976. 

History 

1 . New section filed 12-8-76 as an emergency; effecfive upon filing (Register 76, 
No. 50). 

2. Certificate of Compliance filed 3-8-77 (Register 77, No. 1 1). 

3. Amendment filed 9-8-77; effective thirtieth day thereafter (Register 77, No. 
37). 

4. Repealer filed 10-14-83; designated effective 10-17-83 pursuant to Govern- 
ment Code Section 1 1346.2(d) (Register 83, No. 42). 



Article 12. Procedures and Requirements 

Relating to the California Environmental 

Quality Act 

§ 90950. Statement of Policy. 

(a) It is the policy of the Office of Statewide Health Planning and De- 
velopment, in carrying out its responsibilities under Part 1.5 of Division 
1, Health and Safety Code, to follow all applicable procedures and re- 
quirements of the California Environmental Quality Act and of Chapter 
3, Division 6, Title 14, California Administrative Code, which imple- 
ments CEQA. 

(b) When acting as a lead agency the Office shall follow procedures 
estabhshed by the California Environmental Quahty Act and by Chapter 
3 of Title 14, California Administrative Code. 

(c) Procedures and requirements set forth in sufficient detail and with 
sufficient clarity in CEQA and its implementing regulations shall not be 
reiterated herein. 

NOTE: Authority cited: Secfion 437.6, Health and Safety Code; and Section 
21082, PubHc Resources Code. Reference: Section 437 et seq.. Health and Safety 
Code; and Secfion 21082, Public Resources Code. 



Page 1204 



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Title 22 



Health Planning and Facility Construction 



§ 91003 



History 

1. New Article 12 (Sections 90950-90962, not consecutive) filed 4-1 1-80; effec- 
tive thirtieth day thereafter (Register 80, No. 15). 

2. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 1 1346.2(d) (Register 83, No. 42). 



§ 90952. General Procedures Relating to CEQA. 

(a) As early as practicable in the Certificate of Need process the Office 
shall determine whether a project is exempt from CEQA according to 
Section 90955. A determination made on the basis of information in a no- 
tice of intent shall be reevaluated if the description of the project in the 
application differs materially from the description in the notice of intent. 

(b) If the Office does not find a project to be exempt from CEQA the 

Office shall keep a copy of the negative declaration or final EIR on file 

with the application. 

NOTE: Authority cited: Sections 437.6, 437.15, 438, 438.2 and 438.3, Health and 
Safety Code; and Section 21082, Public Resources Code. Reference: Sections 
437.15, 438, 438.2 and 438.3, Health and Safety Code; and Section 21082, Public 
Resources Code. 

History 

1. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 11346.2(d) (Register 83, No. 42). 



§ 90955. Categorical Exemption. 

(a) The following list summarizes, within relevant categories estab- 
lished in Title 14, California Administrative Code, commencing with 
Section 15101, types of projects which are or may be subject to Certifi- 
cate of Need requirements but which are categorically exempt from the 
requirements of CEQA. These types of projects involve no significant 
environmental impacts. 

(1) Class 1: existing facilities. This class consists of the operation, re- 
pair, maintenance, or minor alteration of existing structures, facilities, 
equipment, or topographical features, involving little or no expansion of 
use. 

(A) Change of facility bed classification. 

(B) Change of license category. 

(C) Establishment of a new service within an existing facility, uulizing 
existing buildings. 

(D) Acquisition of equipment to be used within existing buildings. 

(E) Acquisition by a facility of any previously existing building or oth- 
er capital item or of land when the type of use is not to be significantly 
changed. 

(F) Addition of beds or dialysis stations within an existing building or 
buildings of a facility, if the capacity of the facility is not increased by 
more than 25 percent. 

(G) Remodeling of existing buildings. 

(2) Class 2: replacement or reconstruction. This class consists of re- 
placement or reconstruction in whole or in part of an existing facility on 
the same site, as long as the replacement or reconstruction does not in- 
crease capacity more than 50 percent and the use of the facility does not 
materially change. 

(3) Class 3: new construction of small structures. This class consists 
of construction and location of single, new, small structures (including 
those appurtenant to existing structures) and installation of small new 
equipment. 

(b) Any project which is not specifically described above but which 
is, in the judgment of the Certificate of Need Division, clearly within the 
scope of any exempt lass described in Title 14, California Administrative 
Code, commencing with Section 15101, shall be deemed to be exempt 
from the requirements of CEQA. 

(c) A written explanation for a finding that a project is categorically 

exempt shall be prepared by the Certificate of Need Division and shall 

be available for public inspection. 

NOTE: Authority cited: Sections 437.6 and 467.2, Health and Safety Code; and 
Section 21084, Public Resources Code. Reference: Sections 437.15 and 438.2, 
Health and Safety Code; and Section 21084, Public Resources Code. 



History 

1. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
enimenl Code Section 1 1346.2(d) (Register 83, No. 42). 

§ 90957. Ministerial Projects. 

Projects exempted from the requirements of Health and Safety Code 
Sections 438 to 438. 13, are ministerial projects with respect to the certifi- 
cate of need and certificate of exemption processes. No negative declara- 
tion, EIR, or finding that the project is categorically exempt shall be nec- 
essary in order for the Office to act on such projects. 
NOTE; Authority cited: Sections 437.6, 437.1 1 and 437.1 19, Health and Safety 
Code; and Section 2 1 080, Public Resources Code. Reference: Sections 437. 1 1 and 
437.1 19, Health and Safety Code; and Section 21080, Public Resources Code. 

History 

1. Amendment filed 10-14-83; designated effective 10-17-83 pursuant to Gov- 
ernment Code Section 11346.2(d) (Register 83, No. 42). 

2. Amendment filed 2-28-85; effective thirtieth day thereafter (Register 85, No. 
9). 

§ 90962. Requirements for Office Acting As Responsible 
Agency. 

(a) The Office shall be a responsible agency under CEQA with respect 
to any project which requires a certificate of need, which is not exempt 
from the requirements of CEQA, which is not ministerial with respect to 
the certificate of need/exemption process, and for which the Office is not 
the lead agency. 

(b) When acting as a responsible agency, the Office shall provide to 
the lead agency such consultation and comments as may be requested, in 
accordance with the requirements of Chapter 3, Division 6, Title 14, Cali- 
fornia Administrative Code. Whenever possible and appropriate, the Of- 
fice shall propose changes in a project which would mitigate any signifi- 
cant environmental effect of the project. 

NOTE: Authority cited: Section 437.6, Health and Safety Code; and Sections 
21002, 21069, 21080.3, 21080.4, 21 104 and 21 153, Public Resources Code. Ref- 
erence: Sections 21002, 21069, 21080.3, 21080.4, 21104 and 21153, Public Re- 
sources Code. 



Chapter 2. 



Eminent Domain Procedures for 
Nonprofit Hospitals 



Article 1. Definitions 

§ 91 001 . Certificate of Necessity. 

"Certificate of Necessity" means the document certifying the Direc- 
tor' s determination that a nonprofit hospital has applied for such certifi- 
cation pursuant to the provisions of Section 91017 and 91019 and has 
been judged in compliance with the provisions of Section 91023 of this 
chapter. 

NOTE: Authority cited: Sections 103, 446.2 and 1260, Health and Safety Code; 
and Section 1 1 1 52, Government Code. Reference: Section 1260, Health and Safe- 
ty Code. 

History 

1. New Chapter 2 (Sections 91001-91023, not consecutive) filed 8-3-77; effec- 
tive thirtieth day thereafter (Register 77, No. 32). 

2. Editorial correction of NOTE filed 2-23-83 (Register 83, No. 9). 

§91003. Department. 

"Department" means the Office of Statewide Health Planning and De- 
velopment. 

NOTE: Authority cited: Sections 103, 446.2 and 1260, Health and Safety Code; 
and Section 11152, Government Code. Reference: Secfion 1 260, Health and Safe- 
ty Code. 

History 

1 . Amendment filed 6-30-78 as an emersency; designated effective at 1 1 :59 p.m. 
on 6-30-78 (Register 78, No. 26). 

2. Certificate of Compliance transmitted to OAH 10-27-78; filed 10-31-78 (Reg- 
ister 78, No. 44). 

3. Amendment filed 3-26-79 as procedural and organizational; effective upon fil- 
ing (Register 79, No. 13). 



Page 1205 



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BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



4. Editorial correction of NOTE filed 2-23-83 (Register 83, No. 9). 

§91005. Director. 

"Director" means the Director of the Office of Statewide Health Plan- 
ning and Development. 

NOTE: Authority cited: Sections 103, 446.2 and 1260, Health and Safety Code; 
and Section 1 1 ]52,GoveninientCode. Reference: Section 1260, Health and Safe- 
ty Code. 

History 

1. Amendment filed 6-30-78 as an emergency; designated effective at 1 1 :59 p.m. 
on 6-30-78 (Register 78, No. 26). 

2. Certificate of Comphance transmitted to OAH 10-27-78; filed 10-3 1 -78 (Reg- 
ister 78, No. 44). 

3. Amendment filed 3-26-79 as procedural and organizational; effective upon fil- 
ing (Register 79, No. 13). 

4. Editorial correction of NOTE filed 2-23-83 (Register 83, No. 9). 



§ 91007. Final Environmental Impact Report. 

"Final Environmental Impact Report" means an Environmental Im- 
pact Report in compliance with Section 21061 of the Public Resources 
Code and Section 15146 of Title 14 of the California Administrative 
Code, and certified in accordance with Section 15085 (g) of Title 14 of 
the California Administrative Code. 

NOTE: Authority cited: Sections 103, 446.2 and 1260, Health and Safety Code; 
and Section 1 11 52, Government Code. Reference: Section 1260, Health and Safe- 
ty Code. 

History 
1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§ 91009. Interested Party. 

(a) "Interested party" means: 

(1) All owners and occupants of real property affected. 

(2) The nonprofit hospital. 

(3) The area health planning agency or health systems agency in the 
area within which the hospital is located. 

(4) A representative of any group of 15 or more individuals or organi- 
zations who reside or are located in the area within which the hospital is 
located, if the group shows to the satisfaction of the hearing officer that 
said group will be affected by the environmental impact of the proposed 
project, or by the impact of the proposed project on the delivery of health 
care services in the community. 

Note: Authority cited: Sections 103, 446.2 and 1260, Health and Safety Code; 
and Section 1 1 1 52, Government Code. Reference: Section 1 260, Health and Safe- 
ty Code. 

History . 
1. Editorial correction of (a)(4) and new NOTE filed 2-23-83 (Register 83, No. 
9). 

§ 91 01 1 . Nonprofit Hospital. 

History 
1 . Repealer filed 6-10-83; effective thirtieth day thereafter (Register 83, No. 24). 

§ 91 01 3. Owners of Real Property Affected. 

(a) "Owners of real property affected" means those persons, and the 
spouses of any such persons, having any legal interest in the real property 
which is the subject of procedures under this chapter. Such persons shall 
include but not be limited to: 

(1) Owners in fee, as sole owners, joint tenants, tenants-in-common 
or by purchase of sale agreements. 

(2) Lessees or tenants. 

(3) Holders of easements or rights of way. 

NOTE: Authority cited: Sections 103, 446.2 and 1260, Health and Safety Code; 
and Section 1 1 152, Government Code. Reference: Section 1260, Health and Safe- 
ty Code. 

History 
1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 



Article 2. General Provisions and 
Procedures 

§91015. Applicability. 

The provisions of this chapter shall apply to nonprofit hospitals exer- 
cising the right of eminent domain under Title 7 of the Code of Civil Pro- 
cedure and Section 1260 of the Health and Safety Code. 
NOTE: Authority cited: Sections 103, 446.2 and 1260, Health and Safety Code; 
and Section 1 1 1 52, Government Code. Reference: Secfion 1260, Health and Safe- 
ty Code. 

History 
1 . Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§ 91 01 7. Existing Facility Application for Certificate of 
Necessity. 

(a) Pursuant to the provisions of Section 1260 of the Health and Safety 
Code, the right of eminent domain exercised by an existing nonprofit 
hospital shall be initiated by filing with the Department an application for 
a Certificate of Necessity on forms provided by the Department. A writ- 
ten notice of such application and of the intention to exercise the right of 
eminent domain shall be given to: 

(1 ) All owners of real property affected. 

(2) AH reasonably discernible occupants of real property affected. 

(3) All reasonably discernible occupants of property within 1000 
yards of the real property affected. 

(b) The written notice shall specify a location in the area within which 
the hospital is located where a copy of the application and supporting 
documents shall be maintained for public inspection. 

(c) At least one copy of the application and supporting documents shall 
be available for public inspection at the place specified between the hours 
of 8:00 a.m. to 12:00 noon and 1:00 p.m. to 5:00 p.m. for a period of at 
least 15 days previous to the hearing. 

(d) If 10 percent or more of the residents of the area in which the hospi- 
tal is located speak a language other than English as their primary lan- 
guage, such written notice shall be in both English and the other lan- 
guage. 

(e) Enclosures to the application shall include: 

(1) Copy of Treasury Department and Franchise Tax Board certifica- 
tion of hospital's nonprofit status and exemption from federal and state 
income tax. 

(2) The following information regarding existing property: 

(A) Official map showing legal description and boundaries, and a writ- 
ten and pictorial description of the present property, including location 
and size of existing buildings. 

(B) Date property was acquired. 

(C) Capital investment of property. 

(D) Appraised value of property. 

(3) The following information regarding community patient service 
provided by present hospital: 

(A) Licensed bed capacity. 

(B) Brief description of types of service available. 

(C) Admissions and patient days per year by place of residence. 

(D) Outpatient clinic visits (if applicable) per year. 

(E) Number of staff physicians and geographic areas from which phy- 
sicians are drawn. 

(F) Number of other employees in each job classification. 

(G) Maximum number of employees on hospital property at one time. 

(4) The following information regarding inadequacy of the present 
property and of alternatives to acquisition. 

(A) Detailed description of the deficiencies of the present physical 
property in relation to the function it performs or proposes to perform. 

(B) Detailed explanation of the ability or inability to perform such 
functions. 

(C) Description of the effect of the deficiencies of the present property 
on the delivery of health care services in the community. 



Page 1206 



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Title 22 



Health Planning and Facility Construction 



§ 91021 



(D) Description of reasonably available alternatives to the project and 
the proposed location which might correct or alleviate the effect of such 
deficiencies and explanation for rejection of each alternative. 

(E) Description of other property owned or held under long-term lease 
by the hospital within the county in which the proposed project is located, 
and explanation for the rejection of that property for construction of the 
proposed project. 

(5) The following information regarding the property on which con- 
demnation is desired: 

(A) Official map showing legal description, boundaries and relation- 
ships to present property. 

(B) Buildings and other improvements, and a detailed description of 
their current use. 

(C) Detailed description of proposed use of property, including specif- 
ic activities to be conducted on the site and projected completion date of 
any construction necessary should acquisition take place. 

(D) Detailed description of efforts to acquire property without con- 
demnation, including: 

1. Duration of negotiations. 

2. Individuals involved. 

3. Amounts and dates of any offers or counteroffers made on sale price 
of property. 

4. Available information on appraised value of property. 

5. Property owner's reasons for refusal to sell if other than disagree- 
ment on price. 

6. Description of projected plans for development or expansion by the 
hospital to be commenced within 10 years from application other than 
those presented in the application. 

(6) Resolution of hospital board of directors including: 

(A) Statement of board's opinion that public interest and necessity re- 
quire acquisition of property. 

(B) Statement of board's familiarity with content of application, in- 
cluding all attachments thereto. 

(C) Board's authorization for application. 

(7) Report of impact of proposed expansion upon delivery of health 
care services in community. 

(8) Final Environmental Impact Report, or Negative Declaration pur- 
suant to Section 15083 of Title 14 of the California Administrative Code. 

(9) Affidavit of service of notice as required in (a) above. 

NOTE: Authority cited: Sections 103, 446.2 and 1260, Health and Safety Code; 
and Section 11 152, Government Code. Reference: Section 1260, Health and Safe- 
ty Code. 

History 

1 . Editorial correction of subsection (e)(2)(A) and new NOTE filed 2-23-83 (Reg- 
ister 83, No. 9). 

§ 91019. New Facility Application for Certificate of 
Necessity. 

(a) Pursuant to the provisions of Section 1 260 of the Health and Safety 
Code, the right of eminent domain exercised by a newly formed nonprofit 
hospital applying to condemn property for the initial establishment of the 
facility shall be initiated by filing with the Department an application for 
a Certificate of Necessity on forms provided by the Department. A writ- 
ten notice of such application and of the intention to exercise the right of 
eminent domain shall be given to: 

(1) All owners of real property affected. 

(2) All reasonably discernible occupants of real property affected. 

(3) All reasonably discernible occupants of property within 1000 
yards of the real property affected. 

(b) The written notice shall specify a location in the area within which 
the hospital is located where a copy of the application and supporting 
documents shall be maintained for public inspection. 

(c) At least one copy of the application and supporting documents shall 
be available for public inspection at the place specified between the hours 
of 8:00 a.m. to 1 2:00 noon and 1 :00 p.m. to 5:00 p.m. for a period of at 
least 1 5 days previous to the hearing. 

(d) If 10 percent or more of the residents of the area in which the hospi- 
tal is located speak a language other than English as their primary lan- 



guage, such written notice shall be in both English and the other lan- 
guage. 

(e) Enclosures to the application shall include: 

(1) Copy of the Treasury Department and Franchise Tax Board certifi- 
cation of hospital's nonprofit status and exemption from federal and state 
income tax. 

(2) The following information regarding community patient service 
planned to be provided by the new hospital: 

(A) Planned licensed bed capacity. 

(B) Brief description of types of service planned. 

(C) Expected admissions and patient days per year. 

(D) Expected outpatient clinic visits (if applicable) per year. 

(E) Expected number of staff physicians and geographic areas from 
which physicians will be drawn. 

(F) Expected number of other employees in each job classification. 

(G) Expected maximum number of employees on hospital property at 
one time. 

(3) The following information regarding the property on which con- 
demnation is desired: 

(A) Official map showing legal description and boundaries. 

(B) Buildings and improvements, and a detailed description of their 
current use. 

(C) Detailed description of proposeduse of property, including specif- 
ic activities to be conducted on the site and projected completion date of 
any construction necessary should acquisition take place. 

(D) Detailed description of efforts to acquire property without con- 
demnation, including: 

1. Duration of negotiations. 

2. Individuals involved. 

3. Amounts and dates of any offers or counteroffers made on sale price 
of property. 

4. Available information on appraised value of property. 

5. Property owner's reasons for refusal to sell if other than disagree- 
ment on price. 

(4) Resolution of hospital board of directors including: 

(A) Statement of board's opinion that public interest and necessity re- 
quire acquisition of property. 

(B) Statement of board's familiarity with content of application, in- 
cluding all attachments thereto. 

(C) Board's authorization for application. 

(5) Report of impact of proposed hospital upon delivery of health care 
services in the community. 

(6) Final Environmental Impact Report, or Negative Declaration pur- 
suant to Section 15083 of Title 14 of the California Administrative Code. 

(7) Affidavit of service of notice as required in (a) above. 

(8) Detailed description of deficiencies in the delivery of health care 
services in the community which the proposed project will correct or alle- 
viate. 

(9) Description of reasonably available alternatives to the project or 
the proposed location which might correct or alleviate such deficiencies 
and explanation for rejection of each alternative. 

NOTE: Authority cited: Sections 103. 446.2 and 1260, Health and Safety Code; 
and Section 11 152, Government Code. Reference: Section 1260, Health and Safe- 
ty Code. 

History 

1. Editorial correction of subsection (d) and new NOTE filed 2-23-83 (Register 
83, No. 9). 



§91021. Public Hearing. 

(a) A public hearing shall be conducted to determine the necessity of 
property acquisition. 

(b) The Department shall provide 1 00 days prior written notice of the 
hearing to all interested parties and the local legislative body and city 
planning authority. 

(c) The Department shall publish notice of the hearing in a newspaper 
of general circulation in the area within which the hospital is located on 



Page 1207 



Register 96, No. 13; 3-29-96 



§ 91023 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



three separate occasions within the 30 days iinmediateiy prior to the hear- 
ing. 

(d) The area health planning agency or health systems agency shall 
make recommendations after public meeting of the area agency regard- 
ing the application to the hearing officer within 90 days of receipt of no- 
tice and such recommendations shall be entered into the record ol' the 
public hearing. A copy of the recommendations of the area agency to the 
hearing officer shall at the same time be submitted to the hospital. 

(e) Upon receipt of the agency's recommendations prior to expiration 
of the 90 day maximum response period, the Department may reschedule 
the hearing for conduct at a date earlier than that originally specified. The 
Department shall provide 10 day prior written notice of any hearing so 
rescheduled to all parties set forth in (b) above. 

(f) The hearing shall: 

(1 ) Be conducted prior to certification of necessity pursuant to the pro- 
visions of Sections 91017, 91019 and 91023 of this chapter. 

(2) Be conducted in accordance with Chapter 5 (commencing with 
Section 1 1500) of Part 1 of Division 3 of Title 2 of the Cahfomia Govern- 
ment Code. 

(3) Be conducted in the area within which the hospital is located. 

(4) Take under consideration the impact of the proposed expansion 
upon the delivery of health care services in the community. 

(5) Take into consideration the Final Environmental Impact Report. 

(6) Assure the right of the nonprofit hospital, and all interested parties 
to the acquisition, to the following: 

(A) Representation by counsel. 

(B) Presentation of oral and written evidence. 

(C) Confrontation and cross-examination of opposing witnesses. 

(7) Be transcribed and the hearing record filed with the Department as 
a public document. 

(g) The hearing officer shall file with the Department, within 10 days 
after the hearing, his findings, recommendations and proposed decision. 
NOTE: Authority cited: Sections 103, 446.2 and 1260, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 1260, Health and Safe- 
ty Code. 

History 

1 . Editorial correction of subsection (e) and new NOTE filed 2-23-83 (Register 
83, No. 9). 

§ 91023. Action upon Application. 

(a) The Director may certify, no later than 90 days after the public hear- 
ing required by Section 91021, that: 

(1) The acquisition of the property sought to be condemned is neces- 
sary for the establishment, operation, or expansion of the nonprofit hos- 
pital. 

(2) The public interest and necessity require the proposed project. 

(3) The proposed project is planned or located in the manner that will 
be most compatible with the greatest public good and the least private in- 
jury. 

(b) The Director shall decline to certify if the above is not established 
by substantial evidence in the record. 

(c) In making such determination, the Director shall take into consid- 
eration and evaluate the following information: 

(1) Application for Certificate of Necessity with attachments. 

(2) Public hearing record. 

(3) Recommendation of the area health planning agency or health sys- 
tems agency. 

(4) Hearing officer's findings, recommendations and proposed deci- 
sion. 

(d) Notwithstanding any other provision of these regulations, the Di- 
rector shall decline to certify according to this Section unless and until 
a Certificate of Exemption or Certificate of Need, if required for the proj- 
ect by Section 437.10 of the Health and Safety Code, has been issued. 
However, the Director shall issue a letter of intent to certify according to 
this Section conditioned on the above requirement. 

(e) The Director may reconsider, revoke or suspend a certificate, prior 
to entry of a final court judgment of condemnation, upon proof of false 



or incorrect application information. The Director may suspend the cer- 
tificate pending a new hearing at any time prior to the commencement of 
the trial on the merits of the action for condemnation of the property at 
issue, on his own motion or on the motion of any interested party, based 
upon evidence presented to the Director under penalty of perjury which 
with reasonable diligence could not have been produced at the hearing 
and which reasonably leads the Director to determine that had this evi- 
dence been produced, his original determination would have more prob- 
ably than not been a denial of certification. Where the certificate is sus- 
pended under this section, a new hearing pursuant to the provision of 
91 02 1 shall be held within 90 days. No new application shall be required, 
(f) Any interested party may request the Director to reconsider the de- 
cision to certify or decline to certify pursuant to this Section, based on the 
materials listed in (c), by submitting written argument in support thereof. 
NOTE: Authority cited: Sections 103, 446.2 and 1260, Health and Safety Code; 
and Section 1 1 152, Government Code. Reference: Section 1260, Health and Safe- 
ty Code. 

History 
1 . Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 



Chapter 3. Freestanding Cardiac 
Catheterization Pilot Project 



Article 1. General Provisions 

§ 911 00. Spatial Requirements. 

NOTE: Authority cited: Section 11152, Government Code; and Section 444.9, 
Health and Safety Code. Reference: Section 444.8, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecutive) filed 
3-3-86 as an emergency; effective upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444.9. For history of former chapter 3 (sections 91 101-91 1 77, not 
consecutive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6, sections 91 100-91160, not consecutive) 
whjch was inadvertently deleted in Register 87, No. 2 and editorial correction 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code section 
444.9 (Register 87, No. 39). 

3. New section filed 10-22-90 as an emergency; operative 10-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing chapter 3, article 1 (sections 
91 100-91 1 16) and .section filed 3-27-96 pursuant to section 100, title 1, Cah- 
fomia Code of Regulations (Register 96, No. 13). 

§91102. Staffing Requirements. 

NOTE: Authority cited: Section 11152, Government Code; and Section 444.9, 
Health and Safety Code. Reference: Section 444.8, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecutive) filed 
3-3-86 as an emergency; effective upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444.9. For history of former Chapter 3 (secUons 91 101-91 177, not 
consecutive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprindng of chapter 3 (articles 1-6, sections 91100-91160, not consecutive) 
which was inadvertently deleted in Register 87, No. 2 and editorial correction 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code section 
444.9 (Register 87, No. 39). 

3. New section filed 10-22-90 as an emergency; operative 10-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect unfil 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatoi7 effect repealing section filed 3-27-96 pursuant to 
section 100, title 1, Cahfomia Code of Regulations (Register 96, No. 13). 

§ 91 1 04. Equipment Requirements. 

NotE: Authority cited: Section 11152, Government Code; and Section 444.9, 
Health and Safety Code. Reference: Section 444.8, Health and Safety Code. 

History 
1. New chapter 3 (articles 1-6, sections 91100-91160, not consecuUve) filed 
3-3-86 as an emergency; effective upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 



Page 1208 



Register 96, No. 13; 3-29-96 



Title 22 



Health Planning and Facility Construction 



§ 91120 



• 



Code section 444.9. For history of former chapter 3 (sections 91 101-91 177, not 
consecutive), see Registers 85, No. 21 ; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6. sections 91100-91 160, not consecutive) 
which was inadvertently deleted in Register 87, No. 2 and editorial conection 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code section 
444.9''(Register 87, No. 39). 

3. New section filed 10-22-90 as an emergency; operative 10-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code,"secUon 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing section filed 3-27-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 13). 

§ 91 1 06. Drug Requirements. 

NOTE: Authority cited: Section 11152, Government Code; and Section 444.9, 
Health and Safety Code. Reference: Section 444.8, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecutive) filed 
3-3-86 as an emergency; effective upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444. 9. For history of former Chapter 3 (sections 91 101 -91 177, not 
consecutive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6, sections 91100-91 160, not consecutive) 
which was inadvertently deleted in Register 87, No. 2 and editorial correction 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emersency language to 1-1-89 pursuant to Health and Safety Code section 
444.9"(Register 87, No. 39). 

3. New section filed 10-22-90 as an emergency ; operative 10-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing section filed 3-27-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 13). 

§ 91108. Emergency Protocol Requirements. 

NOTE; Authority cited: Section 11152, Government Code; and Section 444.9, 
Health and Safety Code. Reference: Section 444.8, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecutive) filed 
3-3-86 as an emergency; effective upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444.9. For history of former chapter 3 (sections 91 1 01-9 1177, not 
consecutive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6, sections 91 100-91160, not consecutive) 
which was inadvertently deleted in Register 87, No. 2 and editorial correction 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code section 
444.9 (Register 87, No. 39). 

3. New section filed 10-22-90 as an emergency; operative 10-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing section filed 3-27-96 pursuant to 
section 100, title 1, California Code of Regulafions (Register 96, No. 13). 

§ 91 1 1 0. Internal Patient Safety Assurance Procedures. 

NOTE: Authority cited: Section 11152, Government Code; and Section 444.9, 
Health and Safety Code. Reference: Section 444.8, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecufive) filed 
3-3-86 as an emergency; effecfive upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444.9. For history of former chapter 3 (sections 91 101-91 177, not 
consecutive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprinfing of chapter 3 (articles 1-6, sections 91 100-91 160, not consecutive) 
which was inadvertently deleted in Register 87, No. 2 and editorial correction 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code section 

444.9'(Register 87, No. 39). 

3. New section filed 1 0-22-90 as an emergency ; operative 1 0-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing section filed 3-27-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 13). 

§ 91 1 1 2. Criteria for the Selection and Exclusion of 
Patients. 

NoTE: Authority cited: Section 11152, Government Code; and Secdon 444.9, 
Health and Safety Code. Reference: Section 444.8, Health and Safety Code. 



History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecutive) filed 
3-3-86 as an emergency; effective upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444.9. For history of former chapter 3 (sections 91 1 01 -9 1 1 77, not 
consecutive), see Registers 85. No. 21; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6. sections 91100-91160, not consecutive) 
which was inadvertently deleted in Register 87, No. 2 and editorial correction 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emereency language to 1-1-89 pursuant to Health and Safety Code section 
444.9^ (Register"87rNo. 39). 

3. New section filed 10-22-90 as an emergency; operative 10-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect unnl 1-1-94 pursuant to 
Health and Safety Code.'seclion 444.9 (Register 90. No. 47). 

4. Change without regulatory effect repealing section filed 3-27-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 13). 

§ 91 1 1 4. Permitted Procedures and Minimums. 

NOTE: Authority cited: Secfion 11152, Government Code; and Section 444.9, 
Health and Safety Code. Reference: Section 444.8, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecufive) filed 
3-3-86 as an einergency; effective upon filing (Register 86, No. 1 0). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444.9. For history of former chapter 3 (sections 91 1 01-91 1 77, not 
consecutive), see Registers 85, No. 21 ; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6, sections 91 100-91 160, not consecutive) 
which was inadvertenfly deleted in Register 87, No. 2 and editorial correction 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code section 
444.9 (Register 87, No. 39). 

3 . Ne w secnon filed 1 0-22-90 as an emergency ; operati ve 1 0-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing secfion filed 3-27-96 pursuant to 
section 100, title I, California Code of Regulations (Register 96, No. 13). 

§ 91 1 1 6. Written Informed Consent. 

NOTE; Authority cited: Section 1 1152, Government Code, Section 444.9, Health 
and Safety Code . Reference: Section 444.8, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecufive) filed 
3-3-86 as an emergency; effective upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect unfil 1-1-89 pursuant to Health and Safety 
Code secdon 444.9. For history of former chapter 3 (secdons 91 101-91 177, not 
consecufive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6, sections 91 100-91 160, not consecufive) 
which was inadvertently deleted in Register 87, No. 2 and editorial correction 
of HISTORY NOTE Nos. I and 2 to reflect extended effective date of 3-3-86 
emergency language to I-I-89 pursuant to Health and Safety Code section 
444.9 (Register 87, No. 39). 

3. New secdon filed 10-22-90 as an emergency; operad ve 1 0-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing section filed 3-27-96 pursuant to 
secdon 100, tide 1, California Code of Regulafions (Register 96, No. 13). 



Article 2. Monitoring 



§ 91 1 20. Data and Patient Utilization. 

NOTE: Authority cited: Secdon 11152, Government Code; and Secdon 444.9, 
Health and Safety Code. Reference: Sections 444.5 and 444.7, Health and Safety 
Code. 

History 

1. New chapter 3 (articles 1-6, secdons 91100-91160, not consecutive) filed 
3-3-86 as an emergency; effecfive upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444.9. For history of former chapter 3 (secdons 91 101-91 177, not 
consecufive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6, sections 91 100-91 160, not consecutive) 
which was inadvertenfly deleted in Register 87, No. 2 and editorial correction 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effecfive date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code section 
444.9 (Register 87, No. 39). 

3. New secfion filed 10-22-90 as an emergency; operad ve 10-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect undl 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing article 2 (sections 91 120-91 128) 
and secdon filed 3-27-96 pursuant to secfion 100, title 1, California Code of 
Regulations (Register 96, No. 13). 



Page 1209 



Register 96, No. 13; 3-29-96 



§91122 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



§ 911 22. Access to Records and Facility Site. 

NOTE; Authority cited: Section 1J152, Government Code; and Section 444.9, 
Healtii and Safety Code. Reference: Sections 444.5 and 444.7, Health and Safety 
Code. 

History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecutive) filed 
3-3-86 as an emergency; effective upon tiling (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444.9. For history of former chapter 3 (sections 91 101-91 177, not 
consecutive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6, sections 91 100-91 160. not consecutive) 
which was inadvertently deleted in Reeister 87, No. 2 and editorial correction 
of HISTORY NOTE Nos. 1 and 2 to rellect extended effective date of 3-3-86 
emersency lansuase to 1-1-89 pursuant to Health and Safety Code section 
444.9^(Regisier 87, No. 39). 

3. New section filed 10-22-90 as an emergency; operative 1 0-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code,"section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing section filed 3-27-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 13). 

§ 91 1 24. Reasons for Suspending/Withdrawing Project 
Approval. 

NOTE: Authority cited: Section 11152, Government Code; and Section 444.9, 
Health and Safety Code. Reference: Section 444.5, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecutive) filed 
3-3-86 as an emergency; effective upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safely 
Code section 444.9. For history of former chapter 3 (sections 91 101-91 177, not 
consecutive), see Registers 85, No. 21 ; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6, sections 91 100-91160. not consecutive) 
whjch was inadvertently deleted in Register 87, No. 2 and editorial cortection 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code section 
444.9 (Register 87rNo. 39). 

3. New section filed 10-22-90 as an emergency; operative 10-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing section filed 3-27-96 pursuant to 
secUon 100, title 1, California Code of Regulafions (Register 96, No. 13). 

§ 91 1 26. Methods of Suspending/Withdrawing Project 
Approval. 

NOTE: Authority cited: Section 11152, Government Code; and Section 444.9, 
Health and Safety Code. Reference: Section 444.5, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecutive) filed 
3-3-86 as an emergency; effecfive upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444.9. For history of former chapter 3 (sections 91 101-91 177, not 
consecutive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6, sections 91 100-91 160, not consecutive) 
which was inadvertently deleted in Register 87, No. 2 and editorial cortection 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code section 
444.9 (Register 87, No. 39). 

3. New section filed 10-22-90 as an emergency ; operative 10-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing section filed 3-27-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 13). 

§ 91 1 28. Hearing Procedure. 

NOTE: Authority cited: Section 11152, Government Code; and Section 444.9, 
Health and Safety Code. Reference: Section 444.5, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecutive) filed 
3-3-86 as an emergency; effective upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444.9. For history of former chapter 3 (sections 91 101-91 177, not 
consecutive), see Registers 85, No. 21 ; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6, sections 91 100-91 160, not consecutive) 
which was inadvertently deleted in Reeister 87, No. 2 and editorial cortection 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code section 
444.9 (Register 87, No. 39). 



3 . New section filed 1 0-22-90 as an emergency; operative 1 0-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, seclion 444.9 (Register 90, No. 47). 

4. Change without regulatoiy effect repealing section filed 3-27-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 13). 



Article 3. Fees 



§91130. Fee. 

NOTE: Authority cited: Section 11152. Goveniment Code; and Secfion 444.9, 
Health and Safety Code. Reference: Section 444.10, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, sections 91100-91160, not consecufive) filed 
3-3-86 as an emergency; effective upon filing (Register 86, No. 1 0). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444.9. For history of former chapter 3 (sections 91 1 01-91 177, not 
consecutive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprinfing of chapter 3 (articles 1-6, secdons 91100-91160, not consecutive) 
which was inadvertently deleted in Register 87, No. 2 and editorial cortection 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code secfion 
444.9 (Register 87>o. 39). 

3. New section filed 10-22-90 as an emergency; operafive 10-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing article 3 (section 91 1 30) and section 
filed 3-27-96 pursuant to section 100, tide 1, California Code of Regulafions 
(Register 96, No. 13). 



Article 4. Operational Requirement 

§91140. Operational Requirement. 

NOTE: Authority cited: Secfion 11152, Government Code; and Secfion 444.9, 
Health and Safety Code. Reference: Secfion 444.8, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, secfions 91100-91160, not consecutive) filed 
3-3-86 as an emergency; effecfive upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until I-I-89 pursuant to Health and Safety 
Code section 444.9. For history of former chapter 3 (sections 91 101-91 177, not 
consecufive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprinfing of chapter 3 (articles 1-6, secfions 91100-91 160, not consecufive) 
which was inadvertently deleted in Register 87, No. 2 and editorial cortecfion 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effecfive date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code section 
444.9 (Register^87, No. 39). 

3. New section filed 10-22-90 as an emergency; operative 1 0-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing article 4 (section 91 1 40) and section 
filed 3-27-96 pursuant to section 100, fitle 1, California Code of Regulations 
(Register 96, No. 13). 



Article 5. 



Compliance with Other Laws and 
Regulations 



§ 91 1 50. Compliance with Other Laws and Regulations. 

NOTE; Authority cited: Secfion 11152, Government Code; and Section 444.9, 
Health and Safety Code. Reference: Secfion 444.8, Health and Safety Code. 

History 

1. New chapter 3 (articles 1-6, secfions 91100-91160, not consecutive) filed 
3-3-86 as an emergency; effecfive upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code secfion 444.9. For history of former chapter 3 (secfions 91 101-91 177, not 
consecutive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprinfing of chapter 3 (articles 1-6, sections 91100-91160, not consecufive) 
which was inadvertently deleted in Register 87, No. 2 and editorial cortection 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effecfive date of 3-3-86 
emergency language to 1-1-89 pursuant to Health and Safety Code section 
444.9 (Register 87, No. 39). 

3. New secfion filed 10-22-90 as an emergency; operative 10-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, secfion 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing article 5 (secfion 911 50) and secfion 
filed 3-27-96 pursuant to section 100, fitle 1, California Code of Regulations 
(Register 96, No. 13). 



Page 1210 



Register 96, No. 13; 3-29-96 



Title 22 



Health Planning and Facility Construction 



§ 91315 



Article 6. Definitions 

§91160. Definitions. 

NOTE; Authority cited: Section 11152, Goveniment Code; and Section 444.9, 
Heaitii and Safety Code. Reference: Section 444.1. Health and Safety Code. 

HfSTORY 

1. New chapter 3 (articles 1-6, sections 91 100-91 160. not consecutive) filed 
3-3-86 as an emergency; effective upon filing (Register 86, No. 10). Emergen- 
cy language shall remain in effect until 1-1-89 pursuant to Health and Safety 
Code section 444.9. For history of former chapter 3 (sections 91 101-91 177, not 
consecutive), see Registers 85, No. 21; and 77, No. 26. 

2. Reprinting of chapter 3 (articles 1-6, sections 91 100-91 160, not consecutive) 
which was inadvertently deleted in Register 87, No. 2 and editorial correction 
of HISTORY NOTE Nos. 1 and 2 to reflect extended effective date of 3-3-86 
emereency language to 1-1-89 pursuant to Health and Safety Code section 
444.9''(Register 87, No. 39). 

3. New section filed 10-22-90 as an emergency; operative 10-22-90 (Register 90, 
No. 47). Emergency language shall remain in effect until 1-1-94 pursuant to 
Health and Safety Code, section 444.9 (Register 90, No. 47). 

4. Change without regulatory effect repealing article 6 (section 9 1 1 60) and section 
filed 3-27-96 pursuant to section 100, fitle 1, California Code of Regulations 
(Register 96, No. 13). 



Chapter 4. Fire Protection Loans 



• 



Article 1. Definitions 

§ 91 301 . Basic Services. 

"Basic services" means those services required to be provided by the 
facility in order to obtain and maintain a license and include, in such com- 
binations as may be applicable to the type of facility to be operated, the 
following: personal care, protection, supervision, assistance, guidance or 
training, planned activities, food service and incidental medical and den- 
tal care. 

NOTE: Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Secdon 11152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 

1. New Chapter 4 (Sections 91301-91343, not consecutive) filed 7-25-78; effec- 
tive thirtieth day thereafter (Register 78, No. 30). 

2. Editorial correction of NOTE filed 2-23-83 (Register 83, No. 9). 

§ 91303. Construction Costs. 

"Construction costs" means the cost of installation of automatic sprin- 
kler systems or detectors responding to invisible products of combustion 
other than heat in accordance with the standards and regulations of the 
State Fire Marshal. Also included in such costs are architectural, engi- 
neering, consultation, plan check, permits, testing, inspection, title and 
recording costs and fees, and all other costs necessary or incidental to ef- 
fect the construction project. 

NOTE: Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 1311 1.3, Health and 
Safety Code. 

History 

1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§91305. Department. 

"Department" means the Office of Statewide Health Planning and De- 
velopment. 

NOTE: Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 
1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§91307. Facility. 

"Facility" means a building or portion thereof maintained and used by 
a children's institution providing basic services and licensed to operate 
as a "Group Home — Children," or a building or portion thereof main- 



tained and used by an institution housing the aged and providing basic 
services and hcensed to operate as a "Group Home — Adults." 
NOTE: Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 131 11.3, Health and 
Safety Code. 

History 

1. Editorial coirection adding NOTE filed 2-23-83 (Register 83, No. 9). 

§ 91 309. Housing for the Aged. 

"Housing for the aged" means a facility which devotes at least 70 per- 
cent of its licensed capacity to housing persons who are either 65 years 
of age or older, or 50 years of age or older if such persons are blind or 
totally disabled, or who are any combination of the above classifications. 

NOTE; Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 13111.3. Health and 
Safety Code. 

History 
1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§ 91 31 1 . Project Property. 

"Project property" means the real property upon which the facility is 
located and upon which construction improvements are made. 
NOTE; Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 1 1 152, Government Code. Reference: Section 131 1 1.3, Health and 
Safety Code. 

History 
1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§91313. Trustee. 

"Trustee" means a third-party to whom funds are legally committed 
in trust, under an express trust or escrow agreement between the borrow- 
er, trustee and the Department. 

NOTE; Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 1311 1.3, Health and 
Safety Code. 

History 
1 . Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 



Article 2. General Provisions 

§91314. Advisory Loan Committee. 

(a) The Advisory Loan Committee shall advise the Department re- 
garding the borrower's financial capability to service the loan. 

(b) The Committee shall be appointed by the Director and shall consist 
of seven members as follows: 

(1) Four shall be appointed from outside State Government. 

(2) Three shall be appointed from state departments. One such mem- 
ber shall be from the Division of Facilities Development of the Depart- 
ment. 

(c) The members shall be highly qualified in the field of financial anal- 
ysis of the operation of, capital outlay for, and construction of health faci- 
hties. 

(d) The members shall file statements of economic interest in accor- 
dance with the provisions of the Department's conflict of interest code. 

(e) No member may participate in any manner, including voting, in the 
decision of the Committee regarding a health facility in which such mem- 
ber has an economic interest. 

(f) Members appointed from outside State Government shall be en- 
titled to claim travel expenses equivalent to those of which state em- 
ployees are entitled. 

NOTE; Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 1 1152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 

1. Editorial correction of subsections (b)(2), (c) and new NOTE filed 2-23-83 
(Register 83, No. 9). 

§91315. General. 

The Department shall, in accordance with the provisions of this chap- 
ter, grant loans to facilities for the purpose of installation of fire protec- 
tion equipment therein. To qualify for a loan, facilities shall be in com- 



Page 1211 



Register 96, No. 13; 3-29-96 



§91317 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



pliance with all state laws and local ordinances relating to health, 
sanitation, building safety and licensing. 

NOTE: Authority cited: Sections 103. 446,2 and 446.3, Health and Safety Code; 
and Section 1 ] 152, Government Code. Reference: Section J 311 1.3, Health and 
Safety Code. 

History 

1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§ 91317. Priority of Applications. 

Priority shall be given to applications for loans for facilities in exis- 
tence and licensed prior to the effective date of these regulations and in 
the order in which the initial stage of the applications are perfected by the 
applicant in accordance with the provisions of Section 91337 of these 
regulations. Loans shall be awarded by the Department according to their 
priority only to the extent funds remain available. 

NOTE: Authority cited: Sections 103. 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 

1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§91319. Maximum Loan. 

The maximum amount of the loan shall be no greater than that which 
is determined by the Department as necessary to effect compliance with 
Section 131 13 of the Health and Safety Code. The actual amount of each 
loan shall be determined by the Department, in the exercise of its discre- 
tion, considering the most equitable means of achieving the purpose of 
the program within available funds, taking into account the sums needed 
by each applicant and those needs anticipated for all potential applicants. 

NOTE: Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 

1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§ 91 321 . Length and Maturity of Loans. 

(a) The repayment period for loans shall be limited to the lesser of the 
following: 

(1) Thirty years from the beginning of amortization. 

(2) Seventy-five percent of the Department's estimate of the econom- 
ic life of the facility. 

NOTE; Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section ] 1152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 
1 . Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 



§91323. Interest Rate. 

History 
1 . Repealer filed 6-1 0-83; effective thirtieth day thereafter (Register 83, No. 24). 

§ 91 325. Repayment of the Loan. 

(a) Unless otherwise approved by the Department, the loan shall be re- 
payable in uniform total monthly installments of principal and interest. 

(b) First repayment installment shall be due and payable as specifically 
set forth in the loan agreement, and in no case shal 1 such date be more than 
60 days subsequent to the issuance by the State of the total loan proceeds 
to the trustee. 

(c) The State .shall cause to be issued a Direct Reduction Loan Amorti- 
zation Schedule based upon monthly installment payinents and showing: 

(1) Total ainount of the loan. 

(2) Term of the loan. 

(3) The interest rate. 

(4) Total monthly installment payment. 

(5) Breakdown of monthly interest and principal. 

(6) Balance of loan. 

(d) An installment payment received by the State more than \5 days 
after due date shall be deemed to be delinquent. Upon such delinquency 
a late payment charge of 10 percent of the installment payment may be 
charged to the borrower. The decision on the late charge will be inade by 
the Department after a review of the circumstances involved. 

(e) The borrower may at any time make additional installment pay- 
ments in advance or pay the whole outstanding balance of the loan with- 
out prepayment penalty. 

NOTE: Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 
1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§ 91 327. Security for the Loan. 

(a) Loans may be secured by a first trust deed on the real property of 
the facility upon which the work of construction is performed, or such 
other alternative security as the Department may find necessary to pro- 
tect the financial interests of the State provided that such other security 
agreed upon is sufficient to afford protection of the Department's invest- 
ment. 

(b) The Department shall not accept alternative security in lieu of a 
first trust deed on the real property of the facility unless: 

(1) The borrower applies to the Department for consideration of alter- 
native security arrangements; 



Page 1212 



Register 96, No. 13; 3-29-96 



Title 22 



Health Planning and Facility Construction 



§ 91337 



(2) The borrower substantiates in writing to the Department that if the 
Department requires a first trust deed on the project property of the facil- 
ity, the project would be economically unfeasible; and 

(3) The Department determines and substantiates that the project is 
economically unfeasible without a waiver of the requirement for a first 
taist deed on the project property of the facility. 

(c) The beneficiary of the security shall be the Department. 

NOTE; Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 1 1 152, Government Code. Reference: Section 131 11. 3, Health and 
Safety Code. 

History 

1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§ 91329. Disbursement of Loan Proceeds. 

(a) The proceeds of the loan shall be used exclusively for the construc- 
tion as approved by the Department. 

(b) Upon issuance of the loan by the State, the proceeds of the loan 
shall be deposited with a trustee acceptable to the State who shall operate 
under an express trust agreement. 

(c) Subsequent to execution of the loan agreement and other correla- 
tive documents, the State shall forward the whole amount of the loan to 
the trustee to be deposited in a special construction account from which 
all disbursements shall be made. 

(d) The trustee may invest proceeds of the loan in short-term insured 
securities so long as sufficient funds are held available for timely pay- 
ment of valid claims. Income from such investment shall, after deducting 
agreed charges and costs in favor of the trustee, insure to the benefit of 
the trust loan corpus. 

(e) Prior to valid claims being paid from the construction account and 
upon request by the borrower, a Department representative shall examine 
the borrower's disbursement records and shall certify, on forms fur- 
nished by the Department with respect to such payment to be made, that 
all work, services and materials are incorporated in the project and are in 
compliance with agreements, and regulations and statutes determined 
applicable by the Department. 

NOTE: Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 

1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§ 91 331 . Regulations and Code. 

Any loan agreement entered into pursuant to the Health and Safety 
Code Section 13111.3 and these regulations shall be deemed to include, 
as part of its terms and conditions, all of the provisions of Section 13111.3 
of the Health and Safety Code and of this chapter. 
Note: Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 1 1 152, Government Code. Reference: Section 131 11. 3, Health and 
Safety Code. 

History 
1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§91333. Events of Default. 

(a) The Department may declare a default upon the following condi- 
tions: 

(1) Failure by the borrower to comply with all the terms and conditions 
of the Loan Agreement, the Note, and such other security instruments ex- 
ecuted by the borrower. 

(2) The borrower's noncompliance with laws and regulations pertain- 
ing to the operation and condition of the facility. 

(3) Failure of the borrower to maintain sufficient funds in a trust ac- 
count to prosecute the work of the improvements. 

(4) The borrower's abandonment of the work, property or operation 
of the facility. 

(5) Failure of the borrower to tender an installment payment for a peri- 
od greater than 30 days from due date. 

(6) The borrower' s change of license category without the written con- 
sent of the Department, conveyance of title to the property, transfer of 



possession or purported change of obligor on the loan without express 
approval of the Department. 

(7) Failure of the facility, during the term of the loan, to maintain in 
effect its license in the category of facility under which the loan was is- 
sued. 

(8) Where the borrower files for relief under any chapter of the Federal 
Bankruptcy Act or where an action is filed against the borrower under 
any chapter of the Federal Bankruptcy Act. 

NOTE; Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 1311 1.3, Health and 
Safety Code. 

History 

1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 



§91335. Remedies. 

(a) Upon declaration of default by the Department: 

(1 ) All remaining funds in the trust construction improvement account 
shall revert to the State. 

(2) The total loan balance with accrued interest shall be immediately 
due and payable. 

(b) The Department shall have the right to initiate legal proceedings 
against all obligors and sureties on the loan, and to foreclose upon any 
security given therefor. 

NOTE: Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 

1 . Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 

§ 91337. Applications, Procedures and Approvals. 

(a) Before a loan from the Department may be obtained, the facility 
shall complete and submit an application to the Department. 

(b) Applications shall be processed by the Department in three stages, 
as follows: 

(1) The initial stage material shall be submitted by the applicant to de- 
termine eligibility of the proposed project and shall consist of the follow- 
ing: ' 

(A) Department form LIC-1000, Part A, showing project description 
and costs, applicant's property interest and loan amount. 

(B) Department form LIC-lOOl, Part B. showing financial assets and 
liabilities, and projected income and expenses. 

(C) Department form LIC-1002, Part C, showing nonprofit status and 
resolution to borrow. 

The submission by the applicant of complete and accurate initial stage 
documentation shall constitute perfection of the application for purposes 
of scheduUng priority of the application. 

Subsequent to affirmative action by loan committee, applicant will be 
sent a loan commitment. 

(2) The second stage material in four copies shall be submitted no later 
than three weeks subsequent to the Department's mailing of the loan 
commitment. Failure to submit complete and accurate second stage doc- 
umentation within the time allotted shall subject the application to loss 
of priority. The second stage material shall consist of the following: 

(A) Architect or engineer's agreement, if required by the Department. 

(B) Plans and specifications for the work approved by the Office of the 
State Fire Marshal. 

(C) Vahd contractor's bid offer or an executed contract for the work. 
Verification of competitive bidding shall be required. 

(D) Form of contractor's performance and payment bond. 

(E) Completed state form showing a detailed estimate of costs of all 
items for which the loan proceeds will be used. 

(F) Trustee agreement signed by the parties. 

(G) Loan agreement signed and acknowledged by the applicant. 
(H) Security instrument signed and acknowledged by the applicant. 
(I) Executed promissory note. 

(3) The final stage of the application consists of the following: 



Page 1213 



Register 96, No. 10; 3-8-96 



§ 91339 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



(A) Prior to the closing, the applicant shall submit substantiation of the 
following insurance coverage for work in progress or work to be con- 
structed: 

1. Statutory workmen's compensation and employer's liability. 

2. Bodily injury and property damage liability. 

3. Fire and extended coverage for all work performed under the con- 
tract and other improvements on the site against loss or damage to the 
minimum extent of replacement value covered by the standard coverage 
insurance endorsement. The policies shall include a standard mortgage 
clause making loss payable to the State of California as its interests may 
appear. 

(B) Prior to the closing, the contractor performing the work shall pro- 
vide both performance and payment bonds each i n the amount of 1 00 per- 
cent of the penal sum of the contract. 

(C) The closing of the loan shall take place at such time and place as 
agreed upon by all parties consistent with the completion of all necessary 
document reviews and financial arrangements. 

(D) Actions taken at the closing are to effect a single transaction and 
all documents to be executed and delivered are to be consistent with the 
completion of all necessary document reviews and financial arrange- 
ments. 

(E) All real property security documents are to be recorded with the 
county recorder in the county in which the secured property is located 
prior to closing. 

NOTE: Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 
1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 



§ 91339. Maintenance of Records. 

Commencing with the start of construction, the borrower shall main- 
tain detailed records, upon forms approved by the Department, of all ex- 
penditures made relating to the project construction. 
NOTE: Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 
1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 



§91341. Audit. 

(a) Upon completion of the project, the Department shall cause an au- 
dit to be made of all project-related expenditure records of the borrower. 

(b) Such audited records shall be maintained by the borrower for the 
term of the loan. 

NOTE: Authority cited: Secrions 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 
1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 



§91343. Insurance. 

(a) The borrower, upon completion of any improvements upon the 
project property made pursuant to a loan granted under these regulations, 
shall maintain fire insurance with standard extended coverage endorse- 
ment on all improvements on the property, equal to the current market 
value of such improvements, for the term of the loan. 

(b) Policies shall contain the standard lender's benefit clauses and 
shall name the State of California as joint beneficiary. Copies of periodic 
renewal endorsement certificates shall be provided to the Department. 
NOTE; Authority cited: Sections 103, 446.2 and 446.3, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 13111.3, Health and 
Safety Code. 

History 

1. Editorial correction adding NOTE filed 2-23-83 (Register 83, No. 9). 



Chapter 5. 



Health Facility Construction 
Loan Insurance 



Article 1. Definitions 

§ 91 401 . Advisory Loan Committee. 

"Advisory loan committee" means that committee appointed by the 
Director to advise the Office regarding the borrower's financial capabili- 
ty to service the loan. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 1 1152, Government Code. Reference: Section 436.3, Health and Safety 
Code. 

History 

1. New Chapter 5 (Articles 1-7, Sections 91401-91547, not consecutive) filed 
6-13-79; effective thirtieth day thereafter (Register 79, No. 25). 

2. Amendment of NOTE (Sections 91401-91547, not consecutive) filed 6-21-79 
as procedural and organizational; designated effective 7-13-79 (Register 79, 

No. 25). 

3. Amendment of NOTE filed 12-18-81; effective thirtieth day thereafter (Regis- 
ter 81, No. 51). 

§91403. Affirmative Action. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Section 436.3, Health and Safety 
Code. 

History 

1. Amendment of NOTE filed 12-18-81 ;effecdve thirtieth day thereafter (Regis- 
ter 81, No. 51). 

2. Repealer filed 3-7-96; operative 3-7-96 pursuant to Government Code section 
11343.4(d) (Register 96, No. 10). 

§91405. Applicant. 

"Applicant" means a political subdivision or a nonprofit corporation 
which intends to secure a loan for the construction of a health facility or 
has secured a loan for the construction of a health facility and has applied 
for loan insurance under the Health Facility Construction Loan Insurance 
Law (Section 436 et seq. of the Health and Safety Code and Section 
32127.2 of the Health and Safety Code: See also Article XVL Section 4 
of the Constitution of California). 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 1 1152, Government Code. Reference: Sections 436.3 and 436.9, Health 
and Safety Code. 

History 
1 . Amendment of NOTE filed 12-1 8-81 ; effective thirtieth day thereafter (Regis- 
ter 81, No. 51). 

§91407. Bondliolder. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 

1 . Repealer filed 12-18-81; effective thirtieth day thereafter (Register 8 1 , No. 51). 

§ 91 409. Borrower. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 

1 . Repealer filed 12-18-81; effective thirtieth day thereafter (Register 8 1 , No. 5 1 ). 

§ 91 41 1 . California Health Facilities Construction Loan 
Insurance Program — State Plan. 

NOTE: Authority cited: Sections 436.3 and 436.4, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1. Repealer filed 12-1 8-81; effective thirtieth day thereafter (Register 81, No. 51). 

§ 91 41 3. Contract of Insurance. 

"Contract of insurance" means a document executed by the borrower 
and the Office providing for loan insurance under Section 436 et seq. of 
the Health and Safety Code and Section 32127.2 of the Health and Safety 
Code. See also Article XVL Section 4 of the Constitution of California. 



Page 1214 



Register 96, No. 10; 3-8-96 



Title 22 



Health Planning and Facility Construction 



§ 91453 



NOTE: Authority cited: Sections 436.3 and 446.2, Healtii and Safety Code; and 
Section 1 1 1 52, Government Code. Reference: Sections 436.3 and 32 1 27.2, Health 
and Safety Code. 

History 

] . Amendment of NOTE filed 12-18-81; effective thirtieth day thereafter (Regis- 
ter 81, No. 51). 

§91415. Construction. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

HtSTORY 
1 . Repealer filed 1 2-1 8-81 ; effective thirtieth day thereafter (Register 81 , No. 5 J ). 

§91417. Council. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 12-18-81; effective thirtieth day thereafter (Register 81 , No. 5 1 ). 

§91419. Days. 

"Days" means calendar days unless otherwise specified. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 

Section 11 152, Government Code. Reference: Section 436.3, Health and Safety 

Code. 

History 

1 . Amendment of NOTE filed 1 2-18-8 1 ; effective thirtieth day thereafter (Regis- 
ter 81, No. 51). 

§91421. Debenture. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1. Repealer filed 12-18-81; effective thirtieth day thereafter (Register 81, No. 51 ). 

§91423. Office. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 12-18-81 ; effective thirtieth day thereafter (Register 81 , No. 5 1 ). 

§91425. Director. 

NOTE: Authority cited: Section 436.3, Health and Safety Code. Reference: Sec- 
tions 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 12-1 8-8 1 ; effective thirtieth day thereafter (Register 8 1 , No. 5 1 ). 

§91427. Fund. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Secfions 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1. Repealer filed 12-18-81 ; effective thirtieth day thereafter (Register 81, No. 51). 

§91429. Health Facility. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 12-18-81; effective thirtieth day thereafter (Register 81, No. 51). 

§ 91431. Health Facility Construction Loan Insurance Law. 

"Health Facility Consti^ction Loan Insurance Law" means Section 
436, et seq., of the Health and Safety Code and Section 32127.2 of the 
Health and Safety Code. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 11152, Government Code. Reference: Section 436.3, Health and Safety 
Code. 

History 
1. Amendment of NOTE filed 12-18-81 ; effective thirtieth day thereafter (Regis- 
ter 81, No. 51). 



§91433. Lender. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 12-18-81; effective thirtieth day thereafter (Register 81 , No. 5 1 ). 

§91435. Loan. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 1 2- 1 8-8 1 ; effecti ve thirtieth day thereafter (Register 8 1 . No. 5 1 ). 

§91437. Loan Insurance. 

"Loan insurance" means the insurance of a loan by the Office pursuant 

to the California Health Facility Constmction Loan Insurance Law. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 1 1 1 52, Government Code. Reference Section 436.3, Health and Safety 
Code. 

History 
1 . Amendment of NOTE filed 12-1 8-81 ; effective thirtieth day thereafter (Regis- 
ter 81, No. 51). 

§91439. Maturity Date. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Secnons 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 12-1 8-8 1 ; effective thirtieth day thereafter (Register 8 1 , No. 51 ). 

§ 91441. Federal Program Definitions. 

NOTE: Authority cited: Section 436.3, Health and Safety Code. Reference: Sec- 
tion 14000, et seq.. Welfare and Institutions Code. 

History 
1. Repealer filed 12-18-81;effectivethirtiethday thereafter (Register 81, No. 51). 

§91443. Mortgage. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 1 2-1 8-8 1 ; effecti ve thirtieth day thereafter (Register 8 1 , No. 5 1 ). 

§91445. Mortgagee. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 12-1 8-81 ; effective thirtieth day thereafter (Register 81, No. 51 ). 

§91447. Mortgagor. 

NOTE; Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 1 2-1 8-8 1 ; effective thirtieth day thereafter (Register 8 1 , No. 51). 

§91449. Nonprofit Corporation. 

NOTE; Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 12-18-81;effeciivethirtiethday thereafter (RegisterSl, No. 51). 

§ 91 451 . Political Subdivision. 

NOTE; Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Section 32127.2, Health and Safety Code. 

History 
1 . Repealer filed 12-18-81; effective thirtieth day thereafter (Register 8 1 , No. 5 1). 

§91453. Project 

"Project" means a plan for and the construction, improvement, expan- 
sion, acquisition, or refinancing of a health facility. 
NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code, and 
Section 11152, Government Code. Reference: Sections 436.3, 436.8 and 436.9, 
Health and Safety Code. 



Page 1215 



Register 96, No. 26; 6-28-96 



§ 91455 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



History 
1 . Amendment filed 12-18-81 ; effective thirtieth day thereafter (Resister 81, No. 
51). 

§ 91 455. Project Property. 

NOTE; Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 12-1 8-81 ; effective thirtieth day thereafter (Register 81 , No. 51 ). 

§ 91457. Public Health Facility. 

NOTE: Authority cited: Sections 436.2 and 436.3, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 1 2-18-81 ; effective thirtieth day thereafter (Register 81, No. 51 ). 

§ 91459. Statewide Health Facilities and Services Plan. 

"Statewide Health Facilities and Services Plan" means the plan which 
reflects statewide needs and desirability for health facility projects and 
services. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Secfion 1 1152, Government Code. Reference: Sections 436.3 and 437.7, Health 
and Safety Code. 

History 

1 . Amendment of NOTE filed 12-1 8-81 ; effective thirtieth day thereafter (Reais- 
ter81,No. 51). 

§91461. Title. 

"Title" means clear title free of all liens and encumbrances with the ex- 
ception of utility easements and governmental assessments of records 
and other exceptions approved by the Director. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Section 436.3, Health and Safety 
Code. 

History 
1 . Amendment of NOTE filed 12-1 8-81 ; effective thirtieth day thereafter (Regis- 
ter 81, No. 51). 



Article 2. General Provisions 

§ 91462. Prohibition Against Transactions with a Conflict 
of Interest. 

No present or former officer, director, member, employee or relative 
of any officer, director, member or employee of the borrower or an affili- 
ate of the borrower or incorporator shall receive any benefit, either direct- 
ly or indirectly, as a result of the application for, or insurance of, a loan 
insured by the office, other than the continuation of salaries and em- 
ployee benefits. 

NOTE; Authority cited: Secdons 129015 and 127020, Health and Safety Code. 
Reference: Sections 5231 and 5233, Corporations Code; Sections 1090 and 
1091.5, Government Code; and Section 129015, Health and Safety Code. 

History 
1. New section filed 6-26-96; operative 7-26-96 (Register 96, No. 26). 

§ 91463. Types of Loans Eligible for Insurance. 

NOTE: Authority cited: Secdons 436.3 and 436.8, Health and Safety Code. Refer- 
ence: Secdons 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 1 2-1 8-8 1 ; effecdve thirtieth day thereafter (Register 8 1 , No. 5 1 ). 

§91465. Security for Loans. 

(a) The Office maintains discretion to require additional security in 
each individual case and to require funded depreciation. 

(b) No security agreements shall be entered into by the borrower af- 
fecting the project property without prior approval by the Office. 

(c) Loans to city, county, city and county or hospital district may be 
evidenced by a duly authorized bond issue. The Office may require addi- 
tional security of the city, county, city and county or hospital district in- 
cluding a mortgage, trust indenture or lien on the project property. Where 
the borrower is a joint powers entity, the loan shall be secured by the first 



mortgage or first lien on the project property. The Office maintains dis- 
cretion to require additional security in each individual case. 
NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 1 1 152, Govemment Code. Reference: Secdons 436.3 and 436.8, Health 
and Safety Code. 

History 

1 . Amendment of subsection (a) filed 12-18-81 ; effective thirtieth day thereafter 
(Register 81, No. 51). 



§ 91467. Determination of Need for Project. 

NoTE: Authority cited: Secdons 436.3, 436.4 and 436.45, Health and Safety Code. 
Reference: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 1 2-1 8-8 1 ; effecdve thirtieth day thereafter (Register 8 1 , No. 5 1 ). 

§ 91469. Applications, Procedures and Approvals. 

(a) The applicant shall complete and submit an application to the Of- 
fice. 

(b) Applications shall be processed by the Office in three stages as fol- 
lows: 

(1) The initial stage material shall be submitted by the applicant to de- 
termine eligibility of the proposed projects as follows: 

(A) Office Form No. OSH-FD-136 showing project costs and health 
facility category. 

(B) Office Form No. OSH-FD-137 showing financial assets of appli- 
cants. 

(C) Office Form No. OSH-FD-135 showing the applicant's interest 
in the site. 

(D) A brief narrative outlining the scope of the project and services to 
be rendered upon completion of the project. 

(E) Drawings, small scale or schematics which include a minimum of 
the following: 

1. Map of community showing location of site. 

2. Plot plan showing property lines and existing and proposed new 
structures positioned on the site. 

3. Floor plans of new and remodeled structures. 

4. Brief construction materials outline specification. 

(2) If the initial stage material shows that the proposed project is pre- 
liminarily eligible for loan insurance, the Office shall notify the applicant 
that the initial stage material submitted is sufficient. 

(3) The second stage material shall be submitted by the applicant sub- 
sequent to the Office's notification as to preliminary eligibility. The 
applicant may submit the second stage material with the initial stage ma- 
terial. The second stage materials shall be processed as follows: 

(A) A standard comprehensive health facility feasibility study shall be 
submitted containing at least the following: 

1. Detailed program narrative describing the need for the health ser- 
vices to be provided, scope of such service, existing services, educational 
or research programs, individual departmental functions, staffing re- 
quirements, working relations and coordinating services with other faci- 
lities in the community. 

2. Detailed financial statements showing audited annual balance sheet, 
income and expenses, source and application of funds for preceding three 
years, and income and expense budget projected for succeeding five 
years. New facilities need only submit the projected budget. Depreci- 
ation schedule shall be included. 

3. An opinion of legal counsel regarding the nonprofit status of the 
applicant and the corporate relationships involving the applicant. 

4. Completed Office Form No. OSH-FD-133 showing corporate rela- 
tionships and nonprofit status. 

5. List of consultants preparing feasibility study. 

(B) Following the analysis of initial and second stage materials by the 
Office and their approval thereof, the initial and second stage materials 
wiU be formally presented to the Advisory Loan Committee for its rec- 
ommendation regarding the applicant' s financial capability to service the 
loan. 



Page 1216 



Register 96, No. 26; 6-28-96 



Title 22 



Health Planning and Facility Construction 



§ 91475 



(C) Upon review of the initial and second stage materials by the Advi- 
sory Loan Committee and receipt of their written recommendation re- 
garding the application, the materials shall be reviewed by the Advisory 
Health Council upon receipt in writing of a letter from the Office inform- 
ing it that an application for loan insurance is ready for closing (the third 
stage). Upon receipt of such letter the Council shall give notice to the 
applicant in writing of the date, place and time of a hearing on the applica- 
tion. 

1 . The Council shall, after public review, advise the Director on insur- 
ing the loan. 

(D) The application shall then be reviewed by the Office. 

(E) Upon the Office's review of the initial and second stage materials 
and approval thereof, it may: 

1 . Issue a preliminary conditional commitment letter for insurance val- 
id for a term not to exceed 12 months and renewable for a term not to ex- 
ceed 12 months where the Office has determined that project need exists, 
that the project is eligible for loan insurance and that the project is finan- 
cially feasible. A commitment shall not be renewed more than once. Re- 
newals may be issued only upon request in writing by the applicant and 
only upon a showing of good cause as determined by the Office. Expira- 
tion of the term of the commitment, applicant's Certificate of Exemption 
or Certificate of Need shall void the application and the commitment. 

(F) The preliminary conditional commitment letter shall contain at 
least the following information: 

1. Type, term and amount of loan for which the commitment was is- 
sued. 

2. Term of the commitment. 

3. Date as of which need for the project was established. 

4. Timetable for completion of the project. 

(G) The decision to grant the loan insurance is within the discretion of 
the Director. Showing need for the project or meeting the eligibility re- 
quirements for loan insurance or establishing financial feasibility of the 
project does not create any entitlement to loan insurance. 

(4) The final stage of the application consists of preparing and schedul- 
ing the loan closing. The applicant shall submit to the Office for review 
two loan closing document packages containing completed copies of all 
state forms and legal documents necessary to effect the closing of the 
loan. No later than one week prior t date of loan closing, the applicant 
shall submit to the Office two copies of the loan closing document pack- 
age as revised. 

(c) Before closing of the loan, the borrower shall have obtained such 
architectural, engineering, geologic, licensing and environmental ap- 
provals as may be required for the specific type of health facility covered 
by the project. 

(d) The health facility shall be designed, the plans and specifications 
shall be reviewed and the work shall be constructed in accordance with 
all applicable laws and regulations. 

(e) Prior to the closing of the loan, the borrower shall submit evidence 
that the following insurance coverage is in effect for work in progress or 
work to be performed or a commitment to provide such before construc- 
tion begins: 

(1) Statutory worker's compensation and employer's liability. 

(2) Bodily injury and property damage liability. 

(3) Fire and extended coverage for all work performed under contract 
and other improvements on the site against loss or damage to the extent 
of replacement value covered by the standard extended coverage insur- 
ance endorsement. The policies shall include a standard mortgage clause 
making loss payable to the mortgagee and the State of California as their 
interests may appear. 

(4) The contractor performing the work shall provide both perform- 
ance and payment bonds in the amount of 100 percent of the total sum 
of the contract. A combined performance and payment bond may be pro- 
vided. 

(f) Prior to closing the architect shall have submitted preliminary plans 
for the entire project. 



(g) Prior to closing the borrower shall have a fixed limit of construction 
cost for the entire project, based on an outline of the scope of the project 
or approved plans and specifications, or; a contract to complete a project 
with a guaranteed maximum price, which fully indicates the entire scope 
of the project. 

(h) No construction will be commenced on any increment of a project 
until at least that increment of the project has received final approval of 
the plans and specifications by the Office. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Sections 436.3 and 436.9, Health 
and Safety Code. 

History 

1 . Amendment of subsection (b) filed 1 2-18-8 1 ; effective thirtieth day thereafter 
(Register 81, No. 51). 

2. Repealer of subsection (i) filed 3-7-96; operative 3-7-96 pursuant to Govern- 
ment Code section 11343.4(d) (Register 96, No. 10). 

§ 91 471 . Disbursement of Loan Proceeds. 

(a) Upon issuance of insurance of the loan by the State, the proceeds 
of the loan and other funds as required by the Office shall be deposited 
with a trustee pursuant to a written agreement which shall contain such 
terms and conditions as approved by the Office. 

(b) The trustee shall, with the Office's approval, disburse such depos- 
ited funds in the following order or priority: 

(1) Payment of existing liens necessary to effect clear title. 

(2) Deposits into special funds or accounts, as required by the Office 
or the lender under the mortgage or deed of trust. 

(3) Payment of valid existing claims, including title and recording 
fees, legal fees, financing charges, consultant fees, architectural and en- 
gineering fees but excluding construction claims set forth in (4) below. 

(4) Payment of valid existing claims for the construction, equipment 
and other charges connected with construction, which shall be paid from 
a construction account established for that purpose. 

(c) Prior to release of funds for payment of claims pursuant to para- 
graph (b)(4) above, the trustee shall have received from the Office: 

(1 ) A certification that the work, services, and materials for which pay- 
ment is claimed have been incorporated into the project. 

(2) Office approval of the proposed release of funds. The amount of 
insured loan proceeds released for payment of each claim shall not ex- 
ceed that percentage of such claim that the total of the insured loan pro- 
ceeds is to the total project cost. An exception may be made for good 
cause when the borrower can clearly demonstrate that total funds for 
project completion will be available on a timely basis. 

NOTE: Authority cited: Sections 436.3, 436.5, and 446.2, Health and Safety Code; 
and Section 11152, Government Code. Reference: Sections 436.3 and 436.5, 
Health and Safety Code. 

History 
1 . Amendment filed 12-1 8-8 1 ; effective thirtieth day thereafter (Register 8 1 , No. 
51). 

§ 91473. Certification and Inspection Fees. 

The Office may consider reduction of the certification and inspection 
fee when construction is completed prior to insuring the loan and when 
existing debt is retired under the insured loan. When the entire project 
consists of refinancing only, there will not be a certification and inspec- 
tion fee. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 11 152, Government Code. Reference: Sections 436.3 and 436.6, Health 
and Safety Code. 

History 
] . Amendment filed 12-18-81 ; effective thirtieth day thereafter (Register 81, No. 

51). 

§91475. Application Fee. 

NOTE: Authority cited: Sections 436.3 and 436.9, Health and Safety Code. Refer- 
ence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer filed 12-18-81; effecti ve thirtieth day thereafter (Register 8 1 , No. 5 1 ). 



Page 1217 



Register 2001, No. 12; 3-23-2001 



§ 91477 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



§ 91477. Insurance Premiums. 

(a) The premium rate charged for the insurance of loans by the Office 
paid by all borrowers shall be three percent (3%) of the total amount of 
principal and interest payable over the term of the loan, unless the bor- 
rower requests and qualifies for a lower premium rate under subsection 
(b) below. 

(b) Borrowers that choose to obtain and do obtain a credit rating of 
CCC or higher from one of the three rating agencies listed below shall 
qualify for the discounted premium rate corresponding to the rating. If 
the Office determines that it is in its best interest, it may allow the use of 
a credit assessment, credit opinion or equivalent from one of the three rat- 
ing agencies listed below, using the rating assigned therein instead of the 
credit rating for this purpose. The borrower shall direct the credit rating 
agency to send the rating (or credit assessment, opinion, or equivalent) 
to the Office, with a copy to the borrower. 





Rating Agencies 




Discounted 


Standard & Pooi 


-'s Moody's 


Fitch 


Premium 


AAA 


Aaa 


AAA 




AA+ 


Aal 


AA+ 


0.80% 


AA 


Aa2 


AA 


0.85% 


AA- 


Aa3 


AA- 


0.90% 


A+ 


Al 


A+ 


1.15% 


A 


A2 


A 


1 .20% 


A- 


A3 


A- 


1 .25% 


BBB+ 


Baal 


BBB+ 


1.80% 


BBB 


Baa2 


BBB 


1.85% 


BBB- 


Baa3 
Below Investment Grade: 


BBB- 


1.90% 


BB+ 


Bal 


BB+ 


2.65% 


BB 


Ba2 


BB 


2.70% 


BB- 


Ba3 


BB- 


2.75% 


B+ 


Bl 


B+ 


2.80% 


B 


B2 


B 


2.85% 


B- 


B3 


B- 


2.90% 


CCC 


CCC 


CCC 


2.95% 




Lower than CCC 




3.00% 



(c) The rating will be used only to determine what premium rate the 
Office will charge that borrower, if the Office decides to insure a loan to 
that borrower. The fact that a borrower is able to obtain a CCC rating or 
above does not entitle that borrower to insurance. 

(d) The Office has determined the use of the procedures set forth in (b) 
above constitute a system for assessing the relative financial risk of a bor- 
rower in compliance with Health and Safety Code section 129051. 
NOTE: Authority cited: Sections 127010and 129015,Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Section 129040, Health and Safety 
Code. 

History 

1 . Amendment filed 12-18-81; effective thirtieth day thereafter (Register 81 , No. 
51). 

2. Repealer and new section filed 3-20-2001 ; operative 3-20-2001 . Amendments 
filed without review by OAL pursuant to the exemption for regulations which 
establish or fix rates, prices, or tariffs (Government Code section 11340.9(g)) 
(Register 2001, No. 12). 

§ 91479. Opinion of Legal Counsel. 

(a) At the time the loan is closed or at the initial loan closing if the loan 
is in stages, the borrower shall furnish to the Office the opinion of legal 
counsel with respect to the following: 

(1) The borrower's legal interest in the property. 

(2) The borrower's authority to finance, construct and maintain the 
project, to issue any proposed obligation and to pledge or mortgage the 



assets and project property offered to secure the loan for which insurance 
is sought. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 1 1152, Government Code. Reference: Sections 436.3 and 436.8, Health 
and Safety Code. 

History 
1 . Amendment filed 12-1 8-8 1 ; effective thirtieth day thereafter (Register 8 1 , No. 
51). 

§91481. Closing of the Loan. 

(a) The closing of the loan shall take place at such time and place as 
agreed upon by all parties consistent with the completion of all necessary 
document reviews and financial arrangements. 

(b) Actions taken at the closing shall constitute a single transaction and 
all documents to be executed and delivered or monies to be delivered 
shall be considered as having been delivered simultaneously. 

(c) All real property security documents shall be recorded prior to clos- 
ing with the county recorder in the county in which the secured property 
is located. 

(d) An executed American Land Title Association (ALTA) title 
policy, written in an amount not less than the principal amount of the loan 
to be insured, with the State designated as an additional insured, shall be 
delivered to the State. After delivery of such title policy, the Office shall 
deliver to the borrower the contract of insurance executed by all parties. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Sections 436.3 and 436.8, Health 
and Safety Code. 

History 

1 . Amendment of subsection (e) filed 1 2-1 8-81 ; effective thirtieth day thereafter 
(Register 81, No. 51). 

2. Order of Repeal of subsection (e) filed 6-3-85 by OAL pursuant to Government 
Code Section 1 1349.7; effective thirtieth day thereafter (Register 85, No. 26). 

§91483. Bidding Procedures. 

(a) (Reserved) 

(b) Construction contract awards shall be made to the lowest responsi- 
ble bidder, based upon competitive lump sum bids for the entire project, 
or bidding in increments as approved by the Office. 

(c) Details of the method of bidding and contracting shall be submitted 
to the Office for approval prior to the execution of the construction con- 
tract. 

(d) The method of bidding and contracting selected shall provide a 
fixed maximum cost of the construction work prior to closing of the loan. 

NOTE: Authority cited: Secfions 436.3 and 446.2, Health and Safety Code; and 
Section 11152, Government Code. Reference: Section 436.3, Health and Safety 
Code. 

History 

1. Amendment of subsection (b) filed 12-18-81; effective thirtieth day thereafter 
(Register 81, No. 51). 

2. Order of Repeal of subsection (a) filed 6-3-85 by OAL pursuant to Government 
Code Section 11349.7; effective thirtieth day thereafter (Register 85, No. 26). 

§ 91485. Affirmative Action. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 11152, Government Code. Reference: Secfion 436.3, Health and Safety 
Code. 

History 

1. Amendment of subsection (c) filed 12-18-81; effective thirtieth day thereafter 
(Register 81, No. 51). 

2. Repealer filed 3-7-96; operative 3-7-96 pursuant to Government Code section 
11343.4(d) (Register 96, No. 10). 

§ 91 487. Maintenance of Records. 

During the period of construcrion and for a minimum of three years 
thereafter, the borrower shall maintain detailed records on forms ap- 
proved by the Office of all expenditures made relating to completion of 



Page 1218 



Register 2001, No. 12; 3-23-2001 



Title 22 



Health Planning and Facility Construction 



§ 91550 



the project. No insured loan proceeds will be advanced until documented 
evidence of work performed is provided with a completed copy of Office 
Form OSH-FD-134. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 11152, Government Code. Reference: Section 436.3, Health and Safety 
Code. 

HrSTORY 
1 . Amendment filed 1 2-1 8-81 ; effective thirtieth day thereafter (Reeister 81 , No. 
51). 

§91489. Equipment. 

(a) The borrower shall fully equip the facility and shall maintain the 
equipment so as to provide for continuous efficient operation of the facil- 
ity and adequate service to the patients. Equipment included in the con- 
tract shall not be acquired by installment contract or lease. 

(b) The borrower shall submit for review and approval a detailed list, 
description and estimated cost of all equipment to be installed or placed 
in the facility. Accompanying such list, description and estimated cost 
shall be Certificates of Need or Exemption where required. 

(c) Where equipment, not included in the project is acquired by the fa- 
cility at a date subsequent to the closing by installment contract or lease, 
such equipment contract must be approved by the Office and shall not 
prohibit assignment of the contract in the event of default or insolvency 
of the original purchaser. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 111 52, Government Code. Reference: Section 436.3, Health and Safety 
Code. 

HtSTORY 

1 . Amendment of NOTE filed 12-1 8-81 ; effecfive thirtieth day thereafter (Regis- 
ter 81, No. 51). 

2. Order of Repeal of subsection (d) filed 6-3-85 by OAL pursuant to Government 
Code Section 1 1349.7; effective thirtieth day thereafter (Register 85, No. 26). 

§ 91491 . Operation upon Completion of Facility. 

The facility shall be operated or licensed only in the category of facility 
stated in the application for loan insurance, except that a facility may seek 
to operate as and be licensed under another category of facility upon ap- 
proval of the State and acquisition of a Certificate of Need permitting 
such change. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 11152, Government Code. Reference: Section 436.3, Health and Safety 
Code. 

History 
] . Amendment of NOTE filed 12-18-81; effective thirtieth day thereafter (Regis- 
ter 81, No. 51). 

§91493. Insurance Coverage. 

(a) The borrower shall upon completion of construction of any im- 
provement upon the property continue to maintain for the term of the loan 
fire insurance with standard extended coverage endorsement on all im- 
provements on the property equal to the current market value of such im- 
provements. 

(b) The insurance policy shall contain the standard mortgagee benefit 
clauses and shall name the State of California as additional insured. 
NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 11 152, Government Code. Reference: Sections 436.3 and 436.8, Health 
and Safety Code. 

History 
1 . Amendment of NOTE filed 12-1 8-81 ; effective thirtieth day thereafter (Regis- 
ter 81, No. 51.) 

§91495. Final Audit. 

Subsequent to payment and satisfaction of all claims regarding the 
completion of construction of the facility, an audit shall be made and co- 
pies of such audit shall be forwarded to the Office by the borrower. This 
audit shall be made by an independent auditing agency, acceptable to the 
Office within six months after project completion. 
NoTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 11152, Government Code. Reference: Section 436.3, Health ad Safety 
Code. 



History 
1. Amendment of NOTE filed 12-18-8] ; effecfive thirtieth day thereafter (Regis- 
ter 81, No. 51). 

§ 91497. Financial Statements. 

The borrower shall submit annually to the Office for the term of the 
insured loan an audited financial statement of the financial status of the 
health facility. Such financial statement shall be prepared by independent 
certified public accountants according to accepted accounting principles. 
NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code: and 
Section 11 152, Government Code. Reference: Section 436.3, Health and Safety 
Code. 

History 

1 . Amendment of NOTE filed 12-18-81 ; effective thirtieth day thereafter (Regis- 
ter 81, No. 51). 

§ 91499. Advisory Loan Insurance Committee. 

(a) The Advisory Loan Insurance Committee ("Committee") shall ad- 
vise the Office regarding the borrower's financial capability to service 
the loan. 

(b) The Committee shall be appointed by the Director of the Office and 
shall consist of nine members as follows: 

(1) Seven shall be appointed from outside State Government. 

(2) Two from inside State Government. 

(c) The members of the Committee shall be qualified in the field of fi- 
nancial analysis of the operation of, capital outlay for, or construction of 
health facilities or in the health care professions or by experience in the 
management of non-profit health facilities eligible for insurance under 
the California Health Facility Construction Loan Insurance Law. 

(d) The members shall file statements of economic interest in accor- 
dance with the provisions of the Office's conflict of interest code. 

(e) No member may participate in any manner, including voting, in the 
decision of the Committee regarding a health facility in which such mem- 
ber has an economic interest. 

(f) Members appointed from outside State Government shall be en- 
titled to claim travel expenses equivalent to those of which state em- 
ployees are entitled. 

NOTE: Authority cited: Sections 436.3 and 446.2, Health and Safety Code; and 
Section 11152, Government Code. Reference: Section 436.3, Health and Safety 
Code. 

History 

1. Amendment of subsecfion (c) filed 12-18-81; effecfive thirtieth day thereafter 
(Register 81, No. 51). 

2. Amendment of section heading and subsections (a)-(c) filed 3-27-95; opera- 
tive 4-26-95 (Register 95, No. 13). 

§ 91550. Fee for the Performance of Feasibility Studies for 
Federal Loan Insurance Programs. 

(a) For the purposes of this section, "study" means a study of market 
need and feasibility for any federal mortgage insurance program for 
health-related facilities, including the HUD 242 loan insurance program. 

(b) The administrative cost of commissioning a study is a fee of five 
thousandths of one per cent (.005%) of the principal amount of the loan 
applied for by the health-related facility applying for the study; except 
that the minimum fee is $1,000 and the maximum fee is $5,000. 

(c) At the time of requesting a study, the applicant shall pay to the Of- 
fice one-half (1/2) of the fee owed to the Office, calculated pursuant to 
subsection (b) above. This amount is non refundable. 

(d) After the Office selects a consultant, and before the Office executes 
a contract with the consultant for the performance of the study, the appli- 
cant: 

(1) shall pay to the Office the remaiaing one-half (1/2) of the fee owed 
to the Office calculated pursuant to subsection (b) above; and 

(2) shall deposit with the Office an amount sufficient to reimburse the 
Office for the maximum cost of the study to be charged by the consultant, 
as set forth in the proposed contract for the performance of the study. 

(e) After the consultant and the Office sign the contract for the study, 
no part of the fee paid to the Office to cover the administrative costs of 
the Office shall be refundable, even if the applicant cancels or terminates 
its request for the study prior to the completion of the study. 



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§ 92001 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



(t) If for any reason the study is not completed after the consukant and 
the Office sign the contract for the study, no part of the deposit for use 
by the Office to pay the consultant shall be refundable to the applicant 
until after the applicant requests the Office in writing to stop the study and 
the consultant agrees that no additional fees are owed to the consultant. 

(g) If, after the study is completed, the final cost of the study by the 
consultant is less than the amount deposited by the applicant with the Of- 
fice for that purpose, the Office shall refund the balance to the applicant. 
NOTE: Authority cited: Sections 129015 and 127010. Health and Safety Code; and 
Section 11152, Government Code. Reference: Sections 129048 and 129049, 
Health and Safety Code. 

History 
1. New section filed .V19-2001; operative 4-18-2001 (Register 2001, No. 12). 



Article 3. California Health Facilities 

Construction Loan Insurance 

Program — State Plan 

NOTE: Authority cited: Sections 436.3, 436.4, and 446.2, Health and Safety Code; 
and Section 11152, Government Code. Reference: Sections 436.3 and 436.4, 
Health and Safety Code. 

History 

1. Repealer of Article 3 (Sections 91501-91511, not consecutive) and renumber- 
ing of Article 7 (Sections 91545 and 91547) to Article 3 (Sections 91545 and 
91547) filed 12-18-81; effective thirtieth day thereafter (Register 81, No. 51). 
For prior history, see Register 79, No. 25. 

2. Amendment filed 12-18-81 ; effective thirtieth day thereafter (Register 81, No. 
51). 

3. Order of Repeal of Article 3 (Sections 91545 and 91547) filed 6-3-85 by OAL 
pursuant to Government Code Section 1 1 349.7; effective thirtieth day thereaf- 
ter (Register 85, No. 26). 



Article 4. Defaults 

NOTE: Authority cited: Sections 436.3 and 436.13, Health and Safety Code. Ref- 
erence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer of Article 4 (Sections 9151 3-91531, not consecutive) filed 12-18-81; 

effective thirtieth day thereafter (Register 81, No. 51). For prior history, see 

Register 79, No. 25. 



Article 5. Termination of Insurance 

NOTE: Authority cited: Sections 436.3 and 436.23, Health and Safety Code. Ref- 
erence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1. Repealer of Article 5 (Sections 91533-91 537, not consecutive) filed 12-18-81; 

effective thirtieth day thereafter (Register 81, No. 51). For prior history, see 

Register 79, No. 25. 



Article 6. 



Health Facility Construction Loan 
Insurance Fund 



NOTE: Authority cited: Sections 436.3 and 436.26, Health and Safety Code. Ref- 
erence: Sections 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 

History 
1 . Repealer of Article 6 (Secfions 91539-91543, not consecutive) filed 12-18-81 ; 

effecfive thirtieth day thereafter (Register 81, No. 51). For prior history, see 

Register 79, No. 25. 



Article 7. California Health Facilities 

Construction Loan Insurance 

Program — State Plan 

NOTE: Authority cited: Secfions 436.3 and 436.4, Health and Safety Code. Refer- 
ence: Secfions 436.2 and 436.9, Health and Safety Code, Statutes of 1973. 



History 
Renumbering of Article 7 (Sections 91545 and 91547) to Article 3 (Secfions 
91545 and 9l547) filed 12-18-81; effecfive thirtieth day thereafter (Register 
81, No. 51). For prior history, see Register 79, No. 25. 



Chapter 6. 



Health Workforce Pilot Project 
Program 



Article 1. Definitions 

§ 92001 . Deputy Director. 

Deputy Director means the Deputy Director of the Healthcare Work- 
force and Community Development Division of the Office of Statewide 
Health Planning and Development. 

NOTE: Authority cited: Sections 1 2701 and 1 28 1 55, Health and Safety Code; and 
Secfion ] 1 152, Government Code. Reference: Section 128155, Health and Safety 
Code. 

History 

1. New Chapter 6 (Articles 1-7, Sections 92001-92604, not consecufive) filed 
2-13-80; effecfive thirtieth day thereafter (Register 80, No. 7). 

2. Repealer and new secfion filed 7-29-83; effective thirtieth day thereafter (Reg- 
ister 83, No. 31). 

3. Change without regulatory effect amending chapter heading, secfion heading, 
section and Note filed 2-28-2007 pursuant to section 100, tide 1, California 
Code of Regulations (Register 2007, No. 9). 

§ 92002. Clinical Phase. 

"Clinical Phase" means instructor supervised experience with patient 
during which the trainee applies knowledge presented by an instructor. 
NOTE: Authority cited: Sections 127010andl28155,Health and Safety Code; and 
Secfion 11 152, Government Code. Reference: Secfion 128155, Health and Safety 
Code. 

History 

1 . Repealer and new secfion filed 7-29-83; effective thirtieth day thereafter (Reg- 
ister 83, No. 31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, fitle 1, California Code of Regulafions (Register 2007, No. 9). 

§ 92003. Didactic Phase. 

"Didactic Phase" means an organized body of knowledge presented 
by an instructor. 

NOTE: Authority cited: Secfions 127010 and 1281 55, Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Section 128155, Health and Safety 
Code. 

History 

1 . Repealer and new section filed 7-29-83 ; effecfive thirtieth day thereafter (Reg- 
ister 83, No. 31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
secfion 100, fiUe 1, California Code of Regulafions (Register 2007, No. 9). 

§ 92004. Employment/Utilization Phase. 

"Employment/Utilization Phase" means ongoing application of di- 
dacfic and clinical knowledge and skills in an employment setting under 
the supervision of the supervisor. 

NOTE: Authority cited: Sections 127010 and 128155, Health and Safety Code; and 
Section 11152, Government Code. Reference: Sections 128155 and 128180, 
Health and Safety Code. 

History 

1 . Amendment of NOTE filed 7-29-83; effecfive thirtieth day thereafter (Register 
83, No. 31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, title 1, California Code of Regulations (Register 2007, No. 9). 

§ 92005. Employment/Utilization Site. 

"Employment/Utilization Site" means health facility or any clinical 
setting where health care services are provided. 

NOTE: Authority cited: Sections 1 27010 and 1 281 55, Health and Safety Code; and 
Section 11152, Government Code. Reference: Secfions 128135 and 128180, 
Health and Safety Code. 

History 
1 . Amendment of NOTE filed 7-29-83; effecfive thirtieth day thereafter (Register 

83, No. 31). 



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Title 22 



Health Planning and Facility Construction 



§ 92201 



2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, title 1, California Code of Regulations (Register 2007, No. 9). 

§ 92006. Instructor. 

"Instructor" means a person certified or licensed in California to prac- 
tice or teach the knowledge or skills, or both, the trainee is to learn. 
NOTE: Authority cited: Sections 1 2701 and 1 281 55, Health and Safety Code; and 
Section 11 152. Government Code. Reference: Section 128155, Health and Safety 
Code. 

History 

1. Amendment filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 
31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, title 1, Cahfomia Code of RegulaUons (Register 2007, No. 9). 

§ 92007. Program. 

"Program" means the Health Workforce Pilot Project Program admin- 
istered by the Office of Statewide Health Planning and Development. 
NOTE: Authority cited: Sections 1 27010 and 1281 55. Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Section 128155, Health and Safety 
Code. 

History 

1 . Amendment filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 
31). 

2. Change without regulatory effect amending section and Note filed 2-28-2007 
pursuant to section 100, title 1 , California Code of Regulations (Register 2007, 
No. 9). 

§ 92008. Program Staff. 

"Program Staff means the staff of the Office of Statewide Health 
Planning and Development with responsibility for the Health Workforce 
Pilot Projects. 

NOTE: Authority cited: Sections 127010 and 128165, Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Section 128165, Health and Safety 
Code. 

History 

1 . Repealer and new section filed 7-29-83; effective thirtieth day thereafter (Reg- 
ister 83, No. 31). 

2. Change without regulatory effect amending section and Note filed 2-28-2007 
pursuant to section 100, title 1, California Code of Regulations (Register 2007, 
No, 9). 

§ 92009. Project. 

"Project" means a Health Workforce Pilot Project approved by the Di- 
rector. 

NOTE: Authority cited: Sections 127010 and 128155, Health and Safety Code; and 
Secdon 11152, Government Code. Reference: Secfion 128155, Health and Safety 
Code. 

History 

1 . Repealer and new section filed 7-29-83; effective thirtieth day thereafter (Reg- 
ister 83, No. 31). 

2. Change without regulatory effect amending section and Note filed 2-28-2007 
pursuant to section 100, title 1, California Code of Regulations (Register 2007, 
No. 9). 

§ 92010. Project Director. 

"Project Director" means the individual designated by the sponsor to 
have responsibilities for the conduct of the project staff, instructors, su- 
pervisors, and trainees. 

NOTE: Authority cited: Sections 127010and 128155, Health and Safety Code; and 
Secfion 11152, Government Code. Reference: Secfion 128155, Health and Safety 
Code. 

History 

1 . Repealer and new section filed 7-29-83; effective thirtieth day thereafter (Reg- 
ister 83, No. 31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, Utle 1, California Code of Regulations (Register 2007, No. 9). 

§92011. Sponsor. 

"Sponsor" means a community hospital or clinic, nonprofit education- 
al institution, or governmental agency engaged in health or educational 
activities. 

NOTE: Authority cited: Sections 127010 and 1281 55, Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Section 1281 35, Health and Safety 
Code. 



History 

1 . Repealer and new section filed 7-29-83; effective thirtieth day thereafter (Reg- 
ister 83, No. 31). 

2. Change without regulatory effect amending section filed 1 1-16-92 pursuant to 
section 100, tide 1, California Code of Regulations (Register 92, No. 47). 

3. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, tide 1, California Code of Regulations (Register 2007, No. 9). 

§92012. Training Program. 

"Training Program" means an organized educational program that in- 
cludes at least a didactic phase, clinical phase, and usually an employ- 
ment/utilization phase. All or portions of the didactic and clinical phases 
may be concurrent. 

NoTE: Authority cited: Sections 1 270 1 and 1 28 1 55, Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Section 128155, Health and Safety 
Code. 

History 

1 . Repealer and new section filed 7-29-83; effective thirtieth day thereafter (Reg- 
ister 83, No. 31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, title 1, California Code of Regulations (Register 2007, No. 9). 

§92013. Training Program. 

NOTE: Authoritv cited: Section 429.76, Health and Safety Code. Reference: Sec- 
tion 429.71, Health and Safety Code. 

History 
1 . Repealer filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 31 ). 



Article 2. Minimum Standards 

§ 921 01 . Minimum Standards. 

Each pilot project shall: 

(a) Provide for patient safety. 

(b) Provide qualified instructors to prepare trainees. 

(c) Assure that trainees have achieved a minimal level of competence 
before they entered the employment/utilization phase. 

(d) Inform trainees that there is no assurance of a future change in law 
or regulations to legalize their role. 

(e) Demonstrate that the project has sufficient staff to monitor trainee 
performance and to monitor trainee supervision during the employment/ 
utilization phase. 

(1) Possess the potential for developing new or alternative roles for 
health care personnel or for developing a reallocation of health care tasks, 
which would improve the effectiveness of health care delivery systems. 

(g) Demonstrate the feasibility of achieving the project objectives. 

(h) Comply with the requirements of the Health Workforce Pilot Proj- 
ects statute and regulations. 

(i) Comply with at least one of the eligibility criteria provided in Sec- 
tions 128130, 128135, and 128160 of Article 1, Chapter 3, Part 3, Divi- 
sion 107, of the Health and Safety Code. 

NOTE: Authority cited: Sections 127010and 128155, Health and Safety Code; and 
Section 11 152, Government Code. Reference: Section 128165, Health and Safety 
Code. 

History 

1. Amendment filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 
31). 

2. Change without regulatory effect amending subsections (h) and (i) and Note 
filed 2-28-2007 pursuant to section 1 00, title 1, California Code of Regulations 
(Register 2007, No. 9). 



Article 3. Application Procedure 

§ 92201 . Application Forms. 

(a) The application forms and a copy of the Health Workforce Pilot 
Project statute and regulations shall be obtained from program staff. The 
forms shall be filled out completely. 

(b) The sponsor and project director shall certify in writing that they: 

(1) Will not discriminate on the basis of age, sex, creed, disability, 
race, or ethnic origin. 

(2) Will comply with the requirements of the Health Workforce Pilot 
Project statute and regulations. 



Page 1221 



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§ 92202 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



NOTE: Aiilhority cited: Sections 1 2701 and 1 28155. Health and Safety Code; and 
Section 1 1 1 52, Government Code. Reference: Section 1281 55, Health and Safety 
Code. 

History 

1. Amendment filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 
31). 

2. Change without regulatory effect amending subsections (a) and (h)(2) and Note 
filed 2-28-2007 pursuant to section 1 00. title 1, California Code of Regulations 
(Register 2007, No. 9). 

§ 92202. Application Instructions. 

The application instructions shall include, but not be limited to, the fol- 
lowing: 

(a) Number of copies of completed applications to be submitted to the 
program. 

(b) Name, address and telephone number of person to whom the com- 
pleted applications are to be submitted. 

(c) The time period for submission, when applicable. 

NOTE: Authority cited: Sections 127010and 1281 55, HeaUh and Safety Code; and 
Section 1 11 52, Government Code. Reference: Section 128155, Health and Safety 
Code. 

History 

1 . Amendment of NOTE filed 7-29-83: effective thirtieth day thereafter (Register 
83, No. 31). 

2. Change without regulatory effect amending Note fded 2-28-2007 pursuant to 
section 100, title L California Code of Regulations (Register 2007, No. 9). 



Article 4. Content of Application 

§ 92301 . Abstract. 

An abstract shall be submitted with each application. This provides a 
brief description of the information included in the proposal's narrative. 
NOTE: Authority cited: Sections 127010 and 128155, Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Section 128155. Health and Safety 
Code. 

History 

1 . Amendment of NOTE filed 7-29-83; effective thirtieth day thereafter (Register 
83, No. 31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, title 1, California Code of Regulations (Register 2007, No. 9). 

§ 92302. Purpose and Objectives. 

These brief statements describe: 

(a) The purpose(s) of the project. 

(b) The objectives to meet the purpose(s). 

(c) The time plan for accomplishing the objectives. 

NOTE: Authority cited: Sections 12701 and 1281 55, Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Section 128155, Health and Safety 
Code. 

History 

1 . Amendment of NOTE filed 7-29-83; effective thirtieth day thereafter (Register 
83, No. 31). 

2. Change without regulatory effect amending NOTE filed 2-28-2007 pursuant to 
secfion 100, title 1, California Code of Regulations (Register 2007, No. 9). 

§ 92303. Background Information. 

Background information shall include, but not be limited to the fol- 
lowing: 

(a) Documentation of the need for this project. 

(b) A description of the types of patients or clients likely to be seen or 
treated. 

(c) A description of the skills trainees are to learn. 

(d) An identification of existing laws or regulations, or both, that, in 
the absence of Health Workforce Pilot Project statute Section 128125, et 
seq., of the Health and Safety Code, would prevent the preparation and 
utilization of trainees as proposed in this project. 

(e) A description of employment opportunities for trainees after the 
project terminates. 

(f) An identification of other educational programs or groups conduct- 
ing similar projects. 



NOTE: Authority cited: Sections 127010and 1281 55, Health and Safety Code; and 
Section 11152, Government Code. Reference: Sections 128155 and 128165, 
Health and Safety Code. 

History 

1 . Amendment filed 7-29-83; effective thirtieth day thereafter (Reeister 83, No. 
31). 

2. Change without reguiatoi^ effect amending subsecfion (d) and Note filed 
2-28-2007 pursuant to section 100, title 1, California Code of Regulations 
(Register2007, No. 9). 

§ 92304. Sponsor Information. 

Sponsor information shall include, but not be limited to the following: 

(a) A description of the sponsor, including a copy of an organizational 
chart that identifies the project's relationship to the sponsor. 

(b) A copy of a document verifying the sponsor's status as a communi- 
ty hospital or clinic, or non-profit educational institution. 

(c) A description of functions of the project director, instructors and 
other project staff. 

(d) A description of funding source(s) for the project. 

(e) A description of sponsor's previous experience in preparing health 
care workers. 

(f) A description of the composition and functions of an advisory 
group if one currently exists or will be developed to advise the project. 

(g) An identification of collaborative arrangements with other educa- 
tional institutions and/or health care facilities, or both. 

(h) A description and location of facilities used in the didactic and clin- 
ical phases. This shall include the availability of support services such as 
library, equipment, etc. 

NOTE; Authority cited: Sections 127010andl28155,Health and Safety Code; and 
Section 11152, Government Code. Reference: Secfions 128135 and 128155, 
Health and Safety Code. 

History 

1. Amendment filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 
31). 

2. Change without regulatory effect amending subsection (b) and Note filed 
1 1-16-92 pursuant to section 100, Utie 1, California Code of Regulations (Reg- 
ister 92, No. 47). 

3. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, title 1, California Code of Regulations (Register 2007, No. 9). 

§ 92305. Participant Selection Information. 

Participant selection information shall include at least the following: 

(a) Trainee Information. 

(1) Criteria used to select trainees. 

(2) Plan to inform trainees of their responsibilities and limitations un- 
der the Health Workforce Pilot Project statute and regulation. 

(3) Number of proposed trainees. 

(b) Supervisor Information. 

(1) Criteria used to select supervisors. 

(2) Plan to orient supervisors to their roles and responsibilities. 

(3) Number of proposed supervisors. 

(c) Employment/Utilization Site Information. 

(1) Criteria used to select an employment/utilization site. 

NOTE: Authority cited: Sections 127010and 128155,HeaIth and SafetyCode; and 
Section 11152, Government Code. Reference: Sections 128155 and 128180, 
Health and Safety Code. 

History 

1. Amendment filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 
31). 

2. Change without regulatory effect amending subsecfion (a)(2) and Note filed 
2-28-2007 pursuant to section 100, title 1, California Code of Reeulations 
(Register 2007, No. 9). 

§ 92306. Curriculum. 

The curriculum plan shall include, but not be limited to the following: 

(a) A description of the minimum level of competence the trainee shall 
achieve before entering the employment/utilization phase of the project. 

(b) A description of the content required to meet this minimal compe- 
tency. 

(c) A description of the methodology utilized in the didactic and clini- 
cal phases. 

(d) A description of the evaluation process used to determine when 
trainees have achieved the minimum level of competence. 



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Title 22 



Health Planning and Facility Construction 



§ 92312 



• 



(e) An identification in hours and months of the time required to com- 
plete the didactic and clinical phases. 

NOTE: Authority cited: Sections 1 2701 and ] 28 1 55, Health and Safely Code; and 
Section 11152, Government Code. Reference: Sections 128155 and 128180, 
Health and Safety Code. 

History 

1 . Amendment of NOTE filed 7-29-83; effective thirtieth day thereafter (Register 
83, No. 31). 

2. Change without regulatory effect amending NOTE filed 2-28-2007 pursuant to 
section 100, title 1, California Code of Regulations (Register 2007, No. 9). 

§ 92307. Evaluation. 

The evaluation plan shall include, but not be limited to the following: 

(a) A description of the baseline data and information collected about 
the availability or provision of health care delivery, or both, prior to utili- 
zation of trainee. The actual baseline data shall be collected and sub- 
mitted in writing to the program within six (6) months after the project 
is initially approved. 

(b) A description of baseline data and information to be collected 
about trainee performance, acceptance, and cost effectiveness. 

(c) A description of the methodology to be used in collecting and ana- 
lyzing the data about trainee performance, acceptance, and cost effec- 
tiveness. 

(d) The data required in (b) and (c) shall be submitted in writing to the 
program at least annually or as requested by program staff. 

(e) The evaluation plan shall include provision for reviewing and mo- 
difying the project's objectives and methodology at least annually. Re- 
sults of this evaluation and project modification shall be reported to pro- 
gram staff in writing. 

(f) The evaluation plan shall include provision for retaining for two (2) 
years after completion of the pilot project all raw data about trainees and 
the implementation of the project. 

NOTE: Authority cited: Sections 127010and 128155, Healthand Safety Code; and 
Section 11152, Government Code. Reference: Sections 128155 and 128165, 
Health and Safety Code. 

History 

1 . Amendment filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 
31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuaiit to 
section 100, title 1, California Code of Regulations (Register 2007, No. 9). 

§ 92308. Monitoring. 

The monitoring plan shall include, but not be limited to the following: 

(a) A description of the provisions for protecting patients' safety. 

(b) A description of the methodology used by the project director and 
project staff to provide at least quarteriy monitoring of the following: 

(1) Trainee competency. 

(2) Supervisor fulfillment of role and responsibilities. 

(3) Employment/utilization site compliance with selection criteria. 

(c) Acknowledgement that project staff or their designee shall visit 
each employmentyutilization site at least semi-annually. 

(d) The monitoring plan shall also identify a methodology for report- 
ing information to program staff. 

NOTE: Authority cited: Sections 127010 and 1281 55, Health and Safety Code; and 
Section 11152, Government Code. Reference: Secdons 128155 and 128180, 
Health and Safety Code. 

History 

1. Amendment filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 
31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, fitle 1, California Code of Regulations (Register 2007, No. 9). 

§ 92309. Informed Consent. 

The plan used to obtain prior informed consent from patients to be 
treated by trainees or those legally able to give informed consent for the 
patients shall be described. It shall include, but not be limited to the fol- 
lowing: 

(a) A description of the content of the informed consent. 

( 1 ) Explanation of the role and status of the trainee, including the ready 
availability of the trainee's supervisor for consultation. 



(2) Assurance that the patient can refuse care from a trainee without 
penalty for such a request. 

(3) Identification that consenting to treatment by a trainee does not 
constitute assumption of risk by the patient. 

(b) Provision that the content of the informed consent, either written 
or oral, shall be provided in a language in which the patient is fluent. 

(c) Documentation in the patient record that inforined consent has 
been obtained prior to providing care to the patient. 

(d) Provision for obtaining witnesses to informed consent. Written in- 
formed consent must be witnessed. Oral informed consent obtained by 
the trainee shall have a third party document in writing that he/she has 
witnessed the oral consent. 

(e) Informed consent need be obtained only for those tasks, services, 
or functions to be provided as a pilot project trainee. 

(f) A copy of the language of the informed consent shall be included 
in the application. 

NOTE; Authority cited: Sections 12701 and 1 28 1 55, Health and Safety Code; and 
Section 11152, Government Code. Reference: Sections 128150 and 128155, 
Health and Safety Code. 

History 

1. Amendment filed 7-29-83; effecfive thirtieth day thereafter (Register 83, No. 
31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, title 1, California Code of Regulations (Register 2007, No. 9). 

§92310. Costs. 

A plan for determining estimated or projected costs shall include, but 
not be limited to the following: 

(a) An identification of the average cost of preparing a trainee. This 
shall include cost information related to instruction, instructional materi- 
als and equipment, space for conducting didactic and clinical phases, and 
other pertinent costs. 

(b) An identification of the average cost per patient visit for similar 
care rendered by a current provider of care. 

(c) An identification of predicted average cost per patient visit for the 
care rendered by a trainee. 

(d) Specific information relative to these estimated or projected costs 
shall be provided to program staff at the time of annual renewal or as 
otherwise requested. 

NOTE: Authority cited: Sections 127010and 128155, Health and Safety Code; and 
Secfion 11152, Government Code. Reference: Sections 128155 and 128165, 
Health and Safety Code. 

History 

1 . Amendment of NOTE filed 7-29-83; effective thirtieth day thereafter (Register 
83, No. 31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, fitle 1, California Code of Regulations (Register 2007, No. 9). 

§ 9231 1 . Trainee Information. 

A plan to provide information to program staff regarding trainees in 
the employment/utilization phase shall be described. It shall include, but 
not be limited to the following: 

(a) Name, work address and telephone number of the trainee. 

(b) Name, work address and telephone number and license number of 
the supervisor. 

(c) This information shall be submitted in writing to program staff 
within five (5) days of the date trainee enters the employment/utilization 
phase. 

NOTE: Authority cited: Sections 12701 and 1 28 1 55, Health and Safety Code; and 
Section 11152, Government Code. Reference; Sections 128155 and 128180, 
Health and Safety Code. 

History 

1 . Amendment of NOTE filed 7-29-83; effective thirtieth day thereafter (Register 
83, No. 31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, title 1, California Code of Regulations (Register 2007, No. 9). 

§92312. Modifications. 

Any modifications or additions to an approved project shall be sub- 
mitted in writing to program staff. Modifications include, but are not lim- 
ited to the following: 

(a) Changes in the scope or nature of the project. 



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§ 92313 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



(b) Changes in selection criteria for trainees, supervisors, or employ- 
ment/utilization sites. 

(c) Changes in project staff or instructors. 

(1) This change will not require prior approval by program staff, but 
shall be reported to program staff within two (2) weeks after the change 
occurs. 

(2) Curriculum vitae are required on all project staff and instnictors. 

(d) All other modifications require program staff approval prior to im- 
plementation. 

NOTE: Authority cited: Sections ] 27010 and 1 28 1 55, Health and Safety Code; and 
Section 1 1 1 52, Government Code. Reference: Section 1281 55, Health and Safety 
Code, 

History 

1. Amendment filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 
31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, title LCaUfomia Code of Regulations (Register 2007, No. 9). 

§92313. Legal Liability. 

Sponsors and other participants are advised to ascertain the legal li- 
ability they assume when participating in a pilot project. 
NOTE; Authority cited: Sections 127010 and 1281 55, Health and Safety Code; and 
Section 11152, Government Code. Reference: Sections 128145 and 128155, 
Health and Safety Code. 

History 

1 . Amendment of NOTE filed 7-29-83; effective thirtieth day thereafter (Register 
83, No. 31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
secfion 100, title 1, California Code of Regulations (Register 2007, No. 9). 



Article 5. Application Review Process 

§ 92401 . Review Process for New Applications. 

The review process of a completed application shall include, but not 
be limited to the following: 

(a) An initial review conducted by program staff to determine the ap- 
propriateness and completeness of the application. 

(b) Review and comment by technical consultant(s) selected by pro- 
gram staff for review and comment within forty-five (45) calendar days 
from the date on which the application was distributed for review. 

(c) Review and comment by appropriate Healing Arts Boards and pro- 
fessional associations within forty-five (45) calendar days from the date 
on which the application was distributed for review. 

(d) An abstract of the application shall be made available to any inter- 
ested party upon request. 

(e) A complete application shall be available for review in program of- 
fices during normal working hours. 

(0 A public meeting shall be scheduled on a date that is no sooner than 
forty-five (45) calendar days from the date on which the applications 
were distributed for review to discuss the application and comments of 
consultants, reviewers, healing arts boards, professional associations, 
and other interested parties with the applicant. 

(g) Review for state agency applications shall be as noted in this sec- 
tion with the additional procedure of Section 128175 of the Health and 
Safety Code. 

NOTE: Authority cited: Sections 127010 and 128155, Health and Safety Code; and 
Section 11152, Government Code. Reference: Sections 128135, 128155 and 
128175, Health and Safety Code. 

History 

1. Amendment filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 
31). 

2. Change without regulatory effect amending subsection (g) and Note filed 
2-28-2007 pursuant to secfion 100, fitle 1, California Code of Regulations 
(Register 2007, No. 9). 

§ 92402. Review for State Agency Application. 

NOTE; Authority cited: Section 429.76, Health and Safety Code. Reference: Sec- 
tion 429.80, Health and Safety Code. 

History 
1 . Repealer filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 31 ). 



Article 6. Project Approval 

§92501. Initial Approval. 

(a) The Director has the exclusive authority to grant approval or deny 
approval to a pilot project applicant. 

(b) Approval may be for one year or less or until the project is com- 
pleted, whichever is sooner. 

(c) The Director's decision shall be transmitted in writing to the appli- 
cant with copies to interested parties. 

(d) A sponsor whose project has been denied may resubmit a modified 
application after a sixty (60) day waiting period. 

NOTE: Authority cited: Sections 1 2701 and 1 281 55, Health and Safety Code; and 
Section 11 152, Government Code. Reference: Section 128135, Health and Safety 
Code. 

History 

1. Repealer of Article 6 (Sections 92501-92504) and new Article 6 (Section 
92501) filed 7-29-83; effective thirtieth day thereafter (Register 83, No. 31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, title 1, California Code of Regulations (Register 2007, No. 9). 

Article 7. Program Responsibilities 

§92601. Records. 

The program shall maintain the following records: 

(a) A copy of the application, related documents and evaluation data 
on all projects for a minimum of three (3) years after termination of a 
project. These shall be available for public review in the program office 
during regular working hours. 

(b) A list of all trainees who are in the employment/utilization phase. 
This shall be updated at least semi-annually by the sponsors except as 
provided for in Section 9231 1(c). 

(c) Information about project applications, approved projects and the 
status of trainees who are in the employment/utilization phase shall be 
provided to appropriate State regulatory bodies. 

NOTE: Authority cited: Sections 127010 and 128155, Health and Safety Code; and 
Section 11152, Government Code. Reference: Sections 128155 and 128165, 
Health and Safety Code. 

History 

1. Repealer of Article 7 (Sections 92601-92604) and new Ajticle 7 (Secfions 
92601-92604) filed 7-29-83; effecfive thirtieth day thereafter (Register 83, 
No. 31). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, title 1, Califoniia Code of Regulafions (Register 2007, No. 9). 

§ 92602. Project Evaluation. 

The evaluation of approved projects shall include, but not be limited 
to, the following: 

(a) Written information shall be requested periodically by program 
staff to ascertain the progress of the project in meeting its stated objec- 
tives and in complying with program statutes and regulations. 

(b) Periodic site visits shall be conducted to project offices, locations, 
or both, where trainees are being prepared or utilized as noted in Section 
128165. 

NOTE: Authority cited: Secfions 127010 and 128 1 55, Health and Safety Code; and 
Section 11152, Government Code. Reference: Sections 128125 and 128165, 
Health and Safety Code. 

History 
1. Change without regulatory effect amending subsecfion (b) and Note filed 

2-28-2007 pursuant to section 100, fitle 1, California Code of Regulations 

(Register 2007, No. 9). 

§92603. Site Visits. 

Site visits shall include at least the following: 

(a) Determination that adequate patient safeguards are being utilized. 

(b) Validation that the project is complying with the approved or 
amended appUcation. 

(c) Interviews with project participants and recipients of care. 

(d) An interdisciplinary team composed of representatives of the heal- 
ing arts boards, professional organizations, and other State regulatory bo- 



• 



Page 1224 



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Title 22 



Health Planning and Facility Construction 



§ 92702 



dies shall be invited to participate in a site visit. They will receive at least 
fourteen (14) calendar days written notice. 

(e) Written notification of the date, purpose, and principal members of 
the site visit team shall be sent to the project director at least fourteen (14) 
calendar days prior to the date of the site visit. 

(f) Plans to interview trainees, supervisors and patients or to review pa- 
tient records shall be made in advance through the project director. 

(g) Site visits by program staff may be scheduled, after consultation 
with the project sponsor or director, on less than twenty-four (24) hours 
notice when questions of patient or trainee safety necessitate. 

NOTE: Authority cited: Sections 1 270) and ] 281 55, Health and Safety Code; and 
Section 11152, Government Code. Reference: Sections 128125 and 128165, 
Health and Safety Code. 

History 

1 . Editorial correction of Reference cite (Register 95, No. 25). 

2. Change without regulatory effect amending Note filed 2-28-2007 pursuant to 
section 100, title 1, California Code of Regulations (Register 2007, No. 9). 

§ 92604. Continuing Approval. 

(a) Continuing approval shall be contingent upon review of written in- 
formation submitted by the project of the project's progress in meeting 
stated objectives and its compliance with plans described in the approval 
or amended application. 

(b) Approval may be granted for periods of time up to one year as de- 
termined by the Director. 

NOTE: Authority cited: Sections 1 2701 and 1 28 1 55, Health and Safety Code; and 
Section 11152, Government Code. Reference: Sections 128155 and 128180, 
Health and Safety Code. 

History 

1 . Change without regulatory effect amending Note filed 2-28-2007 pursuant to 

section 100, title 1, California Code of Regulations (Register 2007, No. 9). 



Article 8. Project Completion/Termination 

§ 92701 . Completion of Project. 

(a) An approved project shall indicate its intention in writing to discon- 
tinue its status as a Health Workforce Pilot Project. 

(b) A closing report shall be submitted. This report shall include at 
least the following: 

(1) The reasons for discontinuation as a pilot project. 

(2) A summary of pilot project activities including the number of per- 
sons who entered the employment/utilization phase. 

(3) A description of the plan to inform trainees of the project's discon- 
tinuation, and that they are precluded from performing the skills autho- 
rized under the pilot project after discontinuation unless the role has been 
legalized. 

NOTE: Authority cited: Sections 127010 and 1281 55, Health and Safety Code; and 
Section 1 1 152, Government Code. Reference: Section 128155, Health and Safety 
Code. 

History 

1. New Article 8 (Sections 92701 and 92702) filed 7-29-83; effective thirtieth day 
thereafter (Register 83, No. 31). 

2. Change without regulatory effect amending subsection (a) and Note filed 
2-28-2007 pursuant to section 100, title 1, California Code of Regulations 
(Register 2007, No. 9). 

§ 92702. Termination of Project. 

A pilot project may be terminated during the term of approval in the 
following way: 

(a) In the event of a general or non-critical failure to comply with the 
program's statute, regulations or conditions of the approved application, 
a written notice of intent to terminate, stating with specificity the reasons 
for the intended termination, shall be served on the project director and 
sponsor thirty (30) calendar days before the termination is to become ef- 
fective. 

(1) If a project director or sponsor desires to protest the termination, 
that director or sponsor shall, within seven (7) calendar days after service 
of notice of intent to terminate, serve upon the program, written notice 



requesting that an informal conference be scheduled to review the matter 
with the Deputy Director. 

(2) The Deputy Director, or designee, shall hold, within fourteen (14) 
calendar days from the service of the request, an informal conference. 

(A) The project director or sponsor shall have the right to be repre- 
sented by legal counsel and to present oral or written evidence or other 
information in its behalf at the informal conference. 

(B) The representatives of the program shall attend the conference and 
present evidence or information, oral or written, in substantiation of the 
recommended termination. 

1. The conference shall be a simple, informal proceeding and shall not 
be conducted in the manner of a judicial hearing or as a hearing under the 
Administrative Procedure Act (Chapter 5, commencing with Section 
J 1500 of Part 1 of Division 3 of the Government Code), and need not be 
conducted according to technical rules relating to evidence and wit- 
nesses. 

2. Neither the project director, sponsor, nor the program, shall have the 
right to subpoena any witnesses to attend the conference, or to formally 
cross-examine any person testifying at the conference. However, the 
project director or sponsor and the program may present any witnesses 
on their behalf at the conference. 

(C) Within three (3) calendar days of the conclusion of the informal 
conference the Deputy Director shall either recommend the termination 
or withdraw the notice of intent to terminate. The Deputy Director shall 
state the decision in writing and shall immediately transmit a copy of the 
decision to the project director or sponsor. 

(D) If the project director or sponsor desires to contest the decision 
made after the informal conference, that director or sponsor shall serve 
written notice on the Deputy Director within seven (7) calendar days after 
service of the decision of the informal conference. 

(E) If the project director or sponsor fails to notify the Deputy Director 
of the intention to contest the decision of the informal conference within 
the specified time, the decision by the Deputy Director shall be deemed 
a final order of the Director and shall not be subject to further administra- 
tive review. 

(F) Upon notifying the Deputy Director, in writing, of the intention to 
contest the decision of the informal conference the project director or 
sponsor shall, within seven (7) calendar days of the service of the deci- 
sion of informal conference, serve upon the Director and the program a 
memorandum or brief which sets forth, with particularity, the specific 
grounds for contesting the decision and the support for these grounds. 

(G) Within seven (7) calendar days of the service of the project direc- 
tor' s or sponsor' s memorandum or brief, the program may serve a memo- 
randum or brief containing its arguments in support of the decision of the 
informal conference on the Director and the project director or sponsor. 

(H) Within seven (7) calendar days from the service of the program's 
arguments, the project director or sponsor may serve a reply memoran- 
dum or brief containing its arguments to the program' s position of the Di- 
rector and the program. The project director or sponsor shall notify the 
Director in writing within seven (7) calendar days from the service of the 
program's memorandum or brief, if no reply will be filed. 

(I) The Director shall, within seven (7) calendar days from the service 
of the project director's or sponsor's counter arguments, or within seven 
(7) calendar days from the service of the notice that no reply brief will be 
filed, render a decision to either terminate the project or to withdraw the 
notice of intent to terminate. The decision shall be in writing and shall 
state the reasons for the decision. The decision shall be immediately 
transmitted to the project director or sponsor. This decision shall be 
deemed a final order of the Director and shall not be subject to further ad- 
ministrative review. 

(b) In the event of non-compliance with the program's statute, regula- 
tions, or conditions of the approved application, which constitute a threat 
to patient health or safety, project approval shall be immediately sus- 
pended. Notice of suspension, together with a notice of intent to termi- 
nate project approval, shall be provided the project director or sponsor. 
Notice of the suspension and of the intent to terminate may be given in 



Page 1225 



Register 2007, No. 9; 3-2-2007 



§ 94001 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



writing and must state, with particularity, the reasons for the suspension 
and the intended termination; or notice may be given orally, hut must be 
followed within seven (7) calendar days, by a written notice which states, 
with particularity, the reasons lor the suspension and the intended termi- 
nation. A threat to patient health or safety occurs when the physical or 
mental well-being of a patient is in jeopardy from continued perform- 
ance by the pilot project trainee(s). 

( 1) If the project director or sponsor desires to protest the suspension 
or intended termination, that director or sponsor shall, within seven (7) 
calendar days after service of the written notice, serve upon the program 
written notice requesting that an informal conference be scheduled to re- 
view the matter with the Deputy Director. 

(2) The Deputy Director, or designee, shall hold an informal confer- 
ence within fourteen (14) calendar days after service of the project direc- 
tor's or sponsor's request. 

(3) The conference and appeals procedure shall be identical to the pro- 
cedure established in Subsections 92702(a)(2)(A) through (I) of Title 22, 
of the California Administrative Code, except that these provisions shall 
also apply: 

(A) If the decision of the informal conference is that there is no basis 
for the termination of the project approval, the Deputy Director's written 
decision shall contain, in addition to the reasons for the decision, an order 
lifting the suspension of project approval and withdrawing the notice of 
intent to terminate project approval. 

(B) If the decision of the Director is that there is no basis for the termi- 
nation of project approval, the Director's written decision shall contain, 
in addition to the reasons for the decision, an order lifting the suspension 
of project approval and withdrawing the notice of intent to terminate 
project approval. 

(C) If the project director or sponsor fails to protest, in writing, the sus- 
pension or the intended termination within seven (7) calendar days after 
service of the written notice of suspension or intended termination, the 
Deputy Director shall order the termination of the project approval and 
shall serve upon the director or sponsor a notice stating that project ap- 
proval has been terminated and stating the reasons for the termination. 
The decision by the Deputy Director shall be deemed a final order of the 
Director and shall not be subject to further administrative review. 

(D) The temporary suspension shall remain in effect until such time as 
the hearing is completed and the Director has made a final determination 
on the merits provided. However, the temporary suspension shall be 
deemed vacated if the Director fails to make a final determination on the 
merits within seventy (70) days after the original hearing has been com- 
pleted. 

(c) All appropriate regulatory bodies shall be immediately informed 
in writing when procedure to terminate has been instituted by program 
staff. 

(d) Program staff shall notify the project's trainees and trainee' s super- 
vising professional(s), in writing, of the suspension of the project and the 
outcome of any hearing relative to that suspension. 

(e) Trainees are precluded from performing the skills authorized under 

the pilot project when a project is suspended or terminated. 

NOTE: Authority cited: Sections 1 2701 and 1 28 1 55, Health and Safety Code; and 
Section 11152, Government Code. Reference: Sections 128125, 128140 and 
128155, Health and Safety Code. 

History 

1. Editorial correction of subsection (b)(3) filed 9-23-83 (Register 83, No. 39). 

2. Change without regulatory effect amending section and Note filed 2-28-2007 
pursuant to section 100, title 1 , California Code of Regulations (Register 2007, 
No. 9). 



Chapter 7. 



Seismic Structural Safety 
Standards 



Article 1. General Provisions 

§94001. Purpose. 

NOTE: Authority cited: Sections 446.3 and 1 5020. Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safely Code. 

History 

1. New Chapter 7 (Sections 94001-94134, not consecutive) filed 10-1 1-79; effec- 
tive thirtieth day thereafter (Register 79, No. 41). 

2. Change without regulatoiy effect repealing chapter 7 (articles 1-16, sections 
94001-94602), article 1 (sections 94001-94009) and section, filed 4-8-96 pur- 
suant to section 100, title 1, California Code of Regulations (Register 96, No. 
15). 

§ 94003. Scope. 

Note: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1 . Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94005. Authority. 

Note: Authority cited: Secfions 446.3 and 15020, Health and Safety Code. Refer- 
ence: Secfions 15000-15023, Division 12.5, Health and Safety Code. 

History 

1 . Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, Cahfomia Code of Regulations (Register 96, No. 15). 

§ 94007. Interpretation. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94009. Application of Regulations. 

Note: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Secfions 15000-15023, Division 12.5, Health and Safety Code. 

History 
1 . Change without regulatory effect repealing secfion, filed 4-8-96 pursuant to 
section 100, fitle 1, California Code of Regulations (Register 96, No. 15). 



Article 2. Definitions 

§ 9401 1 . Approved Drawings and Specifications. 

Note; Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Secfions 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing article 2 (sections 94011-94033) 

and section, filed 4-8-96 pursuant to secfion 100, title 1, California Code of 

Regulations (Register 96, No. 15). 

§94013. Building. 

NOTE: Authority cited: Secfions 446.3 and 15020, Health and Safety Code. Refer- 
ence: Secfions 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
secfion 100, fitle 1, California Code of Regulafions (Register 96, No. 15). 

§ 94015. Building Safety Board. 

NOTE: Authority cited: Secfions 446.3 and 15020, Health and Safety Code. Refer- 
ence: Secfions 15000-15023, Division 12.5, Health and Safety Code. 



Page 1226 



Register 2007, No. 9; 3-2-2007 



Title 22 



Health Planning and Facility Construction 



§ 94055 



History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§94017. Contract Documents. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94019. Construction, Reconstruction, Alteration and 
Additions. 

NOTE; Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1 . Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94020. Deferred Approvals. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94021 . Department. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94023. Earthquake. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023. Division 12.5, Health and Safety Code. 

History 
1 . Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94025. License. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94027. Professionals Approved As Design Principals. 

Note: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1 . Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94029. Lateral Force Resisting Capacity. 

Note: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94031 . Structural Elements. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Secrions 15000-15023, Division 12.5, Health and Safety Code. 

History 

1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94033. Structural Repairs. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1 . Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 



Article 3. Approval of Drawings and 
Specifications 

§ 94037. Application for Approval of Drawings and 
Specifications. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
I . Change without regulatory effect repealing article 3 (sections 94037-94055) 

and section, fded 4-8-96 pursuant to section 100, title 1, California Code of 

Regulations (Register 96, No. 15). 

§ 94039. Preparation of Drawings and Specifications. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94041 . Site Data. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1. Change without regulatory effect repeahng section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94043. Acceptance of Site Data. 

NOTE: Authority cited: Sections -446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94045. Preliminary Drawings and Outline Specifications. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94047. Acceptance of Preliminary Drawings and Outline 
Specifications. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, Cahfomia Code of Regulations (Register 96, No. 15). 

§ 94049. Contract Drawings and Specifications. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1 . Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94051 . Approval of Contract Drawings and 
Specifications. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94053. Time Limitations for Approval. 

NOTE; Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, fide 1, California Code of Regulations (Register 96, No. 15). 

§ 94055. Incremental Design, Bidding and Construction. 

NOTE; Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, fitle 1, California Code of Regulations (Register 96, No. 15). 



Page 1226.1 



Register 2007, No. 9; 3-2-2007 



§ 94056 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



Article 4. Fees 



§ 94056. Fees. 

NOTE: Authority cited: Sections 446.2, 15046 and 1 5055, Health and Safety Code; 
and Section 11152, Government Code. Reference: Section 15046, Health and 
Safety Code. 

History 

1 . Repealer and new section filed 1-1 1-83; effective upon filing pursuant to Gov- 
ernment Code Section 11346.2(d) (Register 83, No. 3). 

2. Change without regulatory effect repealing article 4 (section 94056) and sec- 
tion, filed 4-8-96 pursuant to section 100, title 1, California Code of Regula- 
tions (Register 96, No. 15). 



Article 5. Approval of Construction 



§ 94057. Time of Beginning Construction. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1. Change without regulatory effect repealing article 5 (sections 94057-94077) 
and section, filed 4-8-96 pursuant to section 100, title 1, California Code of 
Regulations (Register 96, No. 15). 



§ 94059. Notice of Start of Construction. 

Note: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94060. Notice of Suspension of Construction. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1 . Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94061 . Administration of Construction. 

NOTE: Authority cite: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, ntle 1, California Code of Regulations (Register 96, No. 15). 

§ 94063. Responsibility of the Contractor. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1 . Change without regulatory effect repealing section, filed 4-8-96 pursuant to 

section 100, title 1, Califomia Code of Regulations (Register 96, No. 15). 



[The next page is 1227.] 



Page 1226.2 



Register 2007, No. 9; 3-2-2007 



Title 22 



Health Planning and Facility Construction 



§ 94114 



§ 94065. Continuous Inspection of the Work. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94067. Observation by the Department and the 
Department of General Services. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1 , California Code of Regulations (Register 96, No. 15). 

§ 94069. Tests. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-J5023, Division 12.5, Health and Safety Code. 

History 
1 . Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94071 . Verified Reports. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94073. Addenda, Change Orders, and Deferred 
Approvals. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1 . Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94075. Final Approval of the Work. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94077. Records. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1 , California Code of Regulations (Register 96, No. 15). 



Article 6. Appeals Procedures of the 
Building Safety Board 

§ 94081 . Appeals. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing article 6 (sections 94081-94093) 

and section, filed 4-8-96 pursuant to section 100, title 1, California Code of 

Regulations (Register 96, No. 15). 

§ 94083. Informal Conference. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94085. Formal Hearing Request. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 



§ 94087. Public Hearing on Appeal. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Secuons 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94089. Rights of the Appellant. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Secnons 15000-15023, Division 12.5. Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, dtle 1, California Code of Regulations (Register 96, No. 15). 

§ 94091. Appeal Hearing Procedure. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 

§ 94093. Decision on Appeal. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Secnons 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing section, filed 4-8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 15). 



Article 7. General Design Requirements 
(Testing and Inspection) 

§ 94100. Nonbuilding Regulations. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing article 7 (section 94100) and sec- 
tion, filed 4-8-96 pursuant to section 100, title 1, California Code of Regula- 
tions (Register 96, No. 15). 



Article 8. Masonry (Testing and Inspection) 

§ 94106. Nonbuilding Regulations. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing article 8 (section 94106) and sec- 
tion, filed 4-8-96 pursuant to section 100, title 1, California Code of Regula- 
tions (Register 96, No. 15). 



Article 9. Wood (Testing and Inspection) 

§ 941 1 0. Nonbuilding Regulations. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Secfions 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing article 9 (section 94110) and sec- 
tion, filed 4-8-96 pursuant to section 100, title 1, California Code of Regula- 
tions (Register 96, No. 15). 



Article 10. Concrete (Testing and 
Inspection) 

§ 941 1 4. Nonbuilding Regulations. 

NOTE: Authority cited: Sections 446.3 and 15020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 
1 . Change without regulatory effect repealing article 10 (section 941 14) and sec- 
tion, filed 4-8-96 pursuant to section 100, title 1, California Code of Regula- 
tions (Register 96, No. 15). 



Page 1227 



Register 96, Nos. 15-16; 4-19-96 



§ 94118 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



Article 1 1 . Steel and Iron (Testing and 
Inspection) 

§ 94118. Nonbuilding Regulations. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

I. Change without regulatory effect repealing article 1 1 (section 941 18), section 
and fable T22-94ri 8, filed 4-8-96 pursuant to section 100, title 1, California 
Code of Regulations (Register 96, No. 15). 



2. Change without regulatory effect repealing article 16 (section 94602) and sec- 
tion, filed 4-8-96 pursuant to section 100, title 1, California Code of Regula- 
tions (Register 96, No. 15). 



Article 12. 



Aluminum (Testing and 
Inspection) 



§ 94122. Nonbuilding Regulations. 

NOTE: Authority cited: Secdons 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1. Change without regulatory effect repealing article 12 (section 94122) and sec- 
fion, filed 4-8-96 pursuant to section 100, title 1, California Code of Regula- 
fions (Register 96, No. 15). 



Article 13. Excavations, Foundations and 
Retaining Walls (Testing and Inspections) 

§ 94126. Nonbuilding Regulations. 

NOTE: Authority cited: Sections 446.3 and 1 5020, Health and Safety Code. Refer- 
ence: Sections 15000-15023, Division 12.5, Health and Safety Code. 

History 

1. Change without regulatory effect repealing article 13 (section 94126) and sec- 
tion, filed 4-8-96 pursuant to section 100, title 1, California Code of Regula- 
tions (Register 96, No. 15). 



Article 14. Veneer (Testing and inspection) 

§ 94130. Nonbuilding Regulations. 

NOTE: Authority cited: Secdons 446.3 and 15020, Health and Safety Code. Refer- 
ence: Secdons 15000-15023, Division 12.5, Health and Safety Code. 

History 
1 . Change without regulatory effect repealing article 14 (section 941 30) and sec- 
don, filed 4-8-96 pursuant to secdon 100, tide 1, California Code of Regula- 
dons (Register 96, No. 15). 



Article 15. Masonry or Concrete Chimneys, 

Fireplaces and Barbecues (Testing and 

Inspection) 

§94134. Nonbuilding Regulations. 

NOTE: Authority cited: Secdons 446.3 and 15020, Health and Safety Code. Refer- 
ence: Secdons 15000-15023, Division 12.5, Health and Safety Code. 

History 
1. Change without regulatory effect repealing article 15 (section 94134) and sec- 
don, filed 4-8-96 pursuant to secdon 100, tide 1, California Code of Regula- 
dons (Register 96, No. 15). 



Article 16. Contracts 



§ 94602. Qualification Criteria. 

NOTE: Authority cited: Sections 15055 and 15056, Health and Safety Code. Ref- 
erence: Section 15056, Health and Safety Code. 

History 
1. New secdon filed 4—22-85; effecdve thirtieth day thereafter (Register 85, No. 
17). 



Chapter 8. Clinic Renovation 
(Construction) Grant and Loan Program 



Article 1. Definitions 

§ 95000. Advisory Health Council. 

NoTE: Authority and Reference cited: Secdon 437.0, Health and Safety Code, 
Statutes of 1967. 

History 

1. New Chapter 8 (Articles 1-7, Sections 95000-95260, not consecutive) filed 
3-19-80 as an emergency; effecdve upon filing (Register 80, No. 1 2). A Certifi- 
cate of Compliance must be transmitted to OAH within 120 days or emergency 
language will be repealed on 7-18-80. 

2. Certificate of Compliance transmitted to OAL 7-11-80 and filed 7-29-80 
(RegisterSO, No. 31). 

3. Change without regulatory effect repealing chapter 8 (article 1-7, sections 
95000-95260), article 1 (sections 95000-95080) and section, filed 3-18-96 
pursuant to secdon 100, dtle 1 , California Code of Regulations (Register 96, No. 
12). 

§ 95005. Advisory Loan Committee. 

NOTE: Authority and Reference cited: Section 436.3, Health and Safety Code, 
Statutes of 1969. 

History 
1 . Change without regulatory effect repealing section, filed 3-1 8-96 pursuant to 
secdon 100, title 1, California Code of Regulations (Register 96, No. 12). 

§95010. Director. 

NOTE: Authority and Reference cited: Secdons 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1. Change without regulatory effect repealing secdon, filed 3-18-96 pursuant to 
secdon 100, title 1, California Code of Regulations (Register 96, No. 12). 

§95015. Secretary. 

NOTE: Authority and Reference cited: Secdons 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 

1 . Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
secdon 100, dtle 1, California Code of Regulations (Register 96, No. 12). 

§95020. Office. 

NOTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1 . Change without regulator7 effect repealing section, filed 3-1 8-96 pursuant to 
secdon 100, dtle 1, California Code of Regulations (Register 96, No. 12). 

§ 95025. Facility. 

NOTE: Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1 . Change without regulatory effect repealing section, filed 3-1 8-96 pursuant to 
secdon 100, title 1, California Code of Reguladons (Register 96, No. 12). 

§ 95030. Clinic. 

NOTE: Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
secdon 100, dtle 1, California Code of Reguladons (Register 96, No. 12). 

§ 95040. Construction Costs. 

NOTE: Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 

1. Change without regulatory effect repealing secdon, filed 3-18-96 pursuant to 
secdon 100, tide 1, California Code of Reguladons (Register 96, No. 12). 

§ 95045. Renovation. 

NOTE: Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 



Page 1228 



Register 96, Nos. 15-16; 4-19-96 



Title 22 



Health Planning and Facility Construction 



§ 95165 



History 
1 . Change without regulatory effect repealing section, filed 3-1 8-96 pursuant to 
section 100, title 1 , California Code of Regulations (Register 96, No. 12). 

§ 95050. Fixed Capital Equipment. 

NOTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1 . Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 12). 

§ 95055. Underserved Areas. 

Note: Authority and Reference cited: Sections 436.484 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 12). 

§ 95060. Project Property. 

NOTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 

1. Certificate of Compliance including amendment transmitted to OAL 7-11-80 
and filed 7-29-80 (Register 80, No. 31). 

2. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 12). 

§ 95065. Loan. 

NOTE: Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 

1. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 12). 

§ 95070. Borrower. 

NOTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1 . Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
secfion 100, title 1, California Code of Regulations (Register 96, No. 12). 

§ 95075. Mortgage. 

NOTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1 . Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 12). 

§ 95080. Trustee. 

NOTE; Authority and Reference cited: Secfions 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, fitle 1, California Code of Regulations (Register 96, No. 12). 



Article 2. Eligibility 



§ 95090. Applicants. 

NOTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 

Safety Code, Statutes of 1979. 

History 

1. Change without regulatory effect repealing article 2 (section 95090) and sec- 
tion, filed 3-18-96 pursuant to section 100, title 1, California Code of Regula- 
fions (Register 96, No. 12). 



Article 3. Types of Assistance 

§ 95095. Types of Assistance. 

NOTE: Authority and Reference cited: Secfions 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1 . Change without regulatory effect repealing article 3 (sections 95095 — 95120) 

and secfion, filed 3-18-96 pursuant to secfion 100, fitle 1, California Code of 

Regulafions (Register 96, No. 12). 



§ 95100. Advisory Loan Committee. 

NOTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 

1 . Change without regulatory effect repealing section, filed 3-1 8-96 pursuant to 
section 100, fitle 1, Cahfomia Code of Regulations (Register 96, No. 12). 

§ 95120. Awards Procedure for Grants and Loans. 

NOTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1 . Change without regulatory effect repealing section, filed 3-1 8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 12). 

Article 4. General Provisions 

§95130. General. 

History 
1. Change without regulatory effect repealing article 4 (sections 95130-95135) 
and section, filed 3-18-96 pursuant to section 100, fitle 1, California Code of 
Regulations (Register 96, No. 12). 

§ 95135. Grant and Loan Purposes. 

NOTE; Authority and Reference cited: Secfions 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 

I. Change without regulatory effect repealing secfion, filed 3-18-96 pursuant to 
secfion 100, fitle 1, California Code of Regulafions (Register 96, No. 12). 

Article 5. Application for Funds 

§95140. Procedures. 

NOTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1. Change without regulatory effect repealing article 5 (secfions 95140-95150) 

and section, filed 3-18-96 pursuant to section 100, tide 1, California Code of 

Regulations (Register 96, No. 12). 

§95145. Needs. 

NOTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
secfion 100, title 1, California Code of Regulafions (Register 96, No. 12). 

§95150. Coordination. 

NOTE: Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 

1. Change without regulatory effect repealing secfion, filed 3-18-96 pursuant to 
secfion 100, fitle 1, California Code of Regulafions (Register 96, No. 12). 

Article 6. Selection Process 

§ 95155. Notice and Pre-Application. 

division of facilities development 

office of statewide health planning and development 

714 P street, room 916 
SACRAMENTO, CA 95814 

NOTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 

1. Change without regulatory effect repealing article 6 (sections 95155-95170) 
and section, filed 3-18-96 pursuant to section 100, fitle 1, California Code of 
Regulafions (Register 96, No. 12). 

§ 95160. Financial Assistance Application. 

NoTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, tifie 1, California Code of Regulations (Register 96, No. 12). 

§ 95165. Method of Selection of Applicants for Awards. 

NOTE; Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes 1979. 



Page 1229 



Register 2007, No. 32; 8-10-2007 



§ 95170 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



History 
1. Change without regulatoi^ effect repealing section, filed 3-18-96 pursuant to 
section 100, title ], California Code of Regulations (Register 96, No. 12). 

§95170. Encumberment. 

NOTE: Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1 . Change without regulatory effect repealing section, filed 3-1 8-96 pursuant to 
section 100, title 1, Cahfornia Code of Regulations (Register 96, No. 12). 

Article 7. Administration 



§95175. General. 

NOTE: Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 

1. Change without regulatory effect repealing article 7 (sections 95175-95260) 
and section, filed 3-18-96 pursuant to section 100, title 1, California Code of 
Regulations (Register 96, No. 12). 

§ 951 80. Priority of Applications. 

NOTE: Authority and reference cited: Sections 436.484 and 436.485, Health and 
Safety Code. Statutes of 1979. 

History 
1. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, dtle 1, California Code of Regulations (Register 96, No. 12). 

§ 95185. Second Grant Cycle. 

NOTE: Authority and reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, title 1 , California Code of Regulations (Register 96, No. 12). 

§ 95200. Maximum Grant. 

NOTE: Authority and reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 

1. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 12). 

§95210. Loans. 

NOTE: Authority and reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 

1. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, title 1, California Code of Regulafions (Register 96, No. 12). 

§ 95220. Repayment of the Loan. 

Note: Authority and Reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
secnon 100, title 1, California Code of Regulations (Register 96, No. 12). 

§ 95230. Security for the Loan. 

Note: Authority and reference cited: Secfions 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1 . Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 12). 

§ 95240. Disbursement of Loan Proceeds or Grant Awards. 

NOTE: Authority and reference cited: Secfions 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 

1 . Change without regulatory effect repealing section, filed 3-1 8-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 12). 

§ 95250. Events of Default. 

NOTE: Authority and reference cited: Sections 436.484 and 436.485, Health and 
Safety Code, Statutes of 1979. 

History 
1. Change without regulatory effect repealing section, filed 3-18-96 pursuant to 
section 100, title 1, California Code of Regulafions (Register 96, No. 12). 



§ 95260. Remedies. 

NOTE: Authority and reference cited: Sections 436.484 and 436.485, Health and 
Safety Code. Statutes of 1979. 

History 

1. Change without regulatory effect repealing secfion, filed 3-18-96 pursuant to 
section 100, title 1, California Code of Regulations (Register 96, No. 12). 

Chapter 9. Hospital Charges and Fair 
Pricing Policies Reporting 



Article 1 . 



Hospital Charge Description 
Master Reporting 



§ 96000. Definitions. 

For the purposes of this article, the following definitions from Califor- 
nia Health and Safety Code Section 1339.51 apply: 

(a) "Charge description master" means a uniform schedule of charges 
represented by the hospital as its gross billed charge for a given service 
or item, regardless of payer type. 

(b) "Hospital" means a hospital, as defined in subdivision (a), (b), or 
(f) of California Health and Safety Code Section 1250, that uses a charge 
description master. 

(c) "Office" means the Office of Statewide Health Planning and De- 
velopment. 

NOTE: Authority cited: Section 11 152, Government Code. Reference: Secfions 
1339.55 and 1339.56, Health and Safety Code. 

History 

1. Amendment of chapter 9 heading, repeal of article 1 heading and new section 
filed 3-23-2005; operafive 4-22-2005 (Register 2005, No. 12). For prior histo- 
ry of chapter 9 (articles 1-3, sections 96000-96150), see Register 96, No. 17. 

2. Repealer and new chapter 9 heading and new article 1 heading filed 8-8-2007; 
operafive 9-7-2007 (Register 2007, No. 32). 

§ 96005. Charge Description Master Reporting. 

On July 1 , 2005, and annually on July 1 thereafter, each hospital shall 
file with the Office a copy of the hospital's charge description master as 
of June 1 of the same calendar year in one of the following electronic file 
formats: Microsoft Excel (.xls) or Comma Separated Value (.csv). Hard- 
copy documents are not acceptable. 
Note: Authority cited: Secfion 11152, Government Code. Reference: Section 

1339.55, Health and Safety Code. 

History 

1. New secfion filed 3-23-2005; operative 4-22-2005 (Register 2005, No. 12). 
For prior history, see Register 96, No. 17. 

§ 96010. List of Common Outpatient Procedures 
Reporting. 

On July 1, 2006, and annually on July 1 thereafter, each hospital shall 
file with the Office a list of its average charges for 25 common outpatient 
procedures as of June 1 of the same calendar year in one of the following 
electronic file formats: Microsoft Excel (.xls) or Comma Separated Val- 
ue (.csv). Hardcopy documents are not acceptable. 
NOTE: Authority cited: Secfion 11152, Government Code. Reference: Section 

1339.56, Health and Safety Code. 

History 

1. New section filed 3-23-2005; operative 4-22-2005 (Register 2005, No. 12). 

2. Amendment of section heading and section filed 5-8-2006; operafive 
5-8-2006 pursuant to Government Code section 1 1343.4 (Register 2006, No. 
19). 

§ 96015. Estimate of Revenue Increase Reporting. 

On July 1, 2006, and annually on July 1 thereafter, each hospital shall 
file with the Office an estimate of the percentage increase in the hospi- 
tal's gross revenue due to any price increase for charges for patient ser- 
vices during the 1 2-month period beginning with the effective date of the 
previous charge description master filed with the Office. The estimate 
shall include the estimate calculation and supporting documentation in 
one of the following electronic file formats: Microsoft Excel (.xls) or 
Comma Separated Value (.csv). Hardcopy documents are not acceptable. 
NOTE: Authority cited: Secfion 11152, Government Code. Reference: Secfion 
1339.55, Health and Safety Code. 



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Title 22 



Health Planning and Facility Construction 



§ 96045 



History 

1. New section filed 3-23-2005; operative 4-22-2005 (Register 2005, No. 12). 

§ 96020. Methods of Submission. 

Each hospital shall submit the documents required by Sections 96005, 
96010, and 96015 together as attachments to one e-mail to the Office at 
chargemaster@oshpd.ca.gov. Alternatively, each hospital may submit 
the electronic files required by Sections 96005, 96010, and 96015 togeth- 
er on one Compact Disc (CD) by mail to: 

OFFICII OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. 
ACCOUNTING AND REPORTING SYSTEMS SECTION, 
8)8 K STREET, ROOM 400, 
SACRAMENTO, CA, 95814. 

Hardcopy documents are not acceptable. 
NOTE: Authority cited: Section 11152, Government Code. Reference: Sections 
1339.55 and 1339.56, Health and Safety Code. 

History 
1. New section filed 3-23-2005; operative 4-22-2005 (Register 2005, No. 12). 

§ 96025. Request for Modifications to Requirements. 

To obtain modifications to the requirements specified for electronic 
file formats, effective date of the documents, submission date of the doc- 
uments, or methods of submitting electronic files, hospitals shall file 
written requests for modification with the Office. Hospitals shall have an 
Office-approved modification prior to implementation of any change to 
the applicable requirements. Modification requests shall specify the pre- 
cise changes being requested and the reason(s) the changes are needed. 
The Office shall either approve or disapprove requests for modification 
on a case-by-case basis. 

NOTE: Authority cited: Section 11152, Government Code. Reference: Sections 
1339.55 and 1339.56, Health and Safety Code. 

History 
1. New section filed 3-23-2005; operative 4-22-2005 (Register 2005, No. 12). 



Article 2. 



Hospital Fair Pricing Policies 
Reporting 



§ 96040. Definitions. 

For the purposes of this article, the following definitions apply: 

(a) "Hospital" means any facility that is required to be licensed under 
subdivision (a), (b), or (f) of California Health and Safety Code Section 
1250, except a facility operated by the State Department of Mental 
Health or the Department of Corrections. 

(b) "Office" means the Office of Statewide Health Planning and De- 
velopment. 

(c) "Discount payment" means that part of the hospital's charges that 
a financially qualified patient is expected to pay in accordance with 
Health and Safety Code Sections 127405 (b) and 127405 (d). That por- 
tion of the hospital's charges for which payment is not expected from the 
patient due to the pafient's inability to pay is accounted for and reported 
as partial charity care. 

NOTE: Authority cited: Section 11152, Government Code; and Section 127435, 
Health and Safety Code. Reference: Sections 127400, 1 27405 and 127435, Health 
and Safety Code. 

History 
1. New article 2 (sections 96040-96050) and section filed 8-8-2007; operative 
9-7-2007 (Register 2007, No. 32). 

§ 96041 . Hospital Discount Payment and Charity Care 
Policies Reporting. 

Each hospital shall submit a copy of its discount payment policy, char- 
ity care policy, eligibility procedures for those policies, review process, 
and application form for charity care or discount payment programs to 
the Office. This information is due January 1 , 2008, and biennially on 
January 1 thereafter. If a hospital makes no significant change to its dis- 
count payment policy, charity care policy, eligibility procedures for 
those policies, review process, or application form for charity care or dis- 
counted payment programs previously submitted to the Office, the hospi- 



tal inay notify the Office of the lack of change in accordance with Section 
96046 instead of submitting the information. The significance of the 
change shall be evaluated from the perspective of the anticipated impact 
on the populafion intended to benefit from California Health and Safety 
Code Section 127435. 

NOTE; Authority cited: Section 1 1 152, Government Code; and Section 127435, 
Health and Safety Code. Reference: Sections 127405 and 127435, Health and 
Safety Code. 

History 

1 . New section filed 8-8-2007; operative 9-7-2007 (Register 2007, No. 32). 

§ 96042. Electronic Reporting of Hospital Discount 

Payment and Charity Care Policies, Eligibility 
Procedures, and Review Process. 

Each hospital shall submit its discount payment policy, charity care 
policy, eligibility procedures for those policies, and review process to the 
Office as one electronic file in Microsoft Word (.doc). The electronic file 
must clearly identify the hospital's discount payment policy, charity care 
policy, eligibility procedures for those policies, and review process in 
separate, distinct sections of the file. Hardcopy documents are not ac- 
ceptable. 

NOTE; Authority cited: Section 11 152, Government Code; and Section 127435, 
Health and Safety Code. Reference: Sections 127405 and 127435, Health and 
Safety Code. 

History 

1. New section filed 8-8-2007; operative 9-7-2007 (Register 2007, No. 32). 

§ 96043. Electronic Reporting of Hospital Application 
Form for Charity Care or Discount Payment 
Programs. 

Each hospital shall submit its application form for charity care or dis- 
counted payment programs to the Office as one electronic file in one of 
the following file types: Microsoft Word (.doc), or Portable Document 
Format (.pdf). Hardcopy documents are not acceptable. 
NOTE: Authority cited: Section 11152, Government Code; and Section 127435, 
Health and Safety Code. Reference: Sections 127405 and 127435, Health and 
Safety Code. 

History 
1. New section filed 8-8-2007; operative 9-7-2007 (Register 2007, No. 32). 

§ 96044. Reporting Significant Changes to Hospital 

Discount Payment and Charity Care Policies. 

Whenever a hospital makes a significant change to its discount pay- 
ment policy, charity care policy, eligibility procedures for those policies, 
or review process, the hospital must submit a complete copy of the entire 
discount payment policy, charity care policy, eligibility procedures for 
those policies, and review process to the Office in accordance with Sec- 
tions 96042 and 96046. The significance of the change shall be evaluated 
from the perspective of the anticipated impact on the population intended 
to benefit from California Health and Safety Code Section 127435. 
NOTE; Authority cited: Section 11152, Government Code; and Section 127435, 
Health and Safety Code. Reference: Sections 127405 and 127435, Health and 
Safety Code. 

History 
1. New section filed 8-8-2007; operative 9-7-2007 (Register 2007, No. 32). 

§ 96045. Reporting Significant Changes to Hospital 

Charity Care or Discount Payment Programs 
Application Forms. 

Whenever a hospital makes a significant change to its application form 
for charity care or discount payment programs, the hospital must submit 
a complete copy of the entire application form for charity care or discount 
payment programs to the Office in accordance with Sections 96043 and 
96046. The significance of the change shall be evaluated from the per- 
spective of the anticipated impact on the population intended to benefit 
from California Health and Safety Code Section 127435. 
NOTE; Authority cited: Section 11152, Government Code; and Section 127435, 
Health and Safety Code. Reference-. Sections 127405 and 127435, Health and 
Safety Code. 

History 
1. New section filed 8-8-2007; operative 9-7-2007 (Register 2007, No. 32). 



Page 1231 



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§ 96046 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



§ 96046. Method of Submission of Fair Pricing Documents 
and Notifications. 

Each hospital shall submit its discount payment policy, charity care 
policy, eligibility procedures for those policies, review process, and ap- 
plication form for charity care or discount payment programs as electron- 
ic files identified in Sections 96042 and 96043 using the Office's internet 
System for Fair Price Hospital Reporting located on the Office's web site 
at: https://syfphr.oshpd.ca.gov/ . Hospitals shall use a Microsoft Internet 
Explorer web browser that supports a secure internet connection utilizing 
the Secure Hypertext Transfer Protocol (HTTPS orhttps)and 128-bit cy- 
pher strength Secure Socket Layer (SSL) to utilize the Office's internet 
System for Fair Price Hospital Reporting. 

If there are no significant changes to a hospital's discount payment 
policy, charity care policy, eligibility procedures for those policies, re- 
view process, or application form for charity care or discounted payment 
programs previously submitted to the Office and the hospital chooses to 
notify the Office of the lack of changes to the information, the hospital 
shall use the Office's internet System for Fair Price Hospital Reporting 
to notify the Office of the lack of changes. 

NOTE: Authority cited: Section 11 152, Government Code; and Section 127435, 
Health and Safety Code. Reference: Sections 127405 and 127435, Health and 
Safety Code. 

History 
1. New section filed 8-8-2007; operative 9-7-2007 (Register 2007, No. 32). 

§ 96050. Request for Modifications to Requirements. 

To obtain modifications for electronic file types or method of submit- 
ting electronic files or notifications, hospitals shall file written requests 
for modification with the Office. Hospitals shall have an Office- 
approved modification prior to implementation of any change to the ap- 
plicable requirements. Modification requests shall specify the precise 
changes being requested and the reason(s) the changes are needed. The 
Office shall either approve or disapprove requests for modificafion on a 
case-by-case basis. 

NOTE: Authority cited: Section 11 152, Government Code; and Section 127435, 
Health and Safety Code. Reference: Sections 127405 and 127435, Health and 
Safety Code. 

History 
1. New section filed 8-8-2007; operative 9-7-2007 (Register 2007, No. 32). 



Chapter 10. Health Facility Data 
Article 1. General 

§ 97003. Accounting System Requirements. 

(a) The hospital accounting system prescribed by this Chapter shall be 
used by all hospitals licensed pursuant to Chapter 2 (commencing with 
Section 1250) of Division 2, Health and Safety Code. 

(b) The long-term care facility accounfing system prescribed by this 
Chapter shall be used by all skilled nursing facilities, intermediate care 
facilities, intermediate care facilities/developmentally disabled, and con- 
gregate living health facilities licensed pursuant to Chapter 2 (commenc- 
ing with Section 1250) of Division 2, Health and Safety Code. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128760, Health and Safety Code. 

History 

1 . Renumbering and amendment of former title 4, chapter 10 (sections 7003, 7005, 
7007 and 7008) to title 22, division 7 (sections 97003, 97005, 97007 and 97008) 
filed 11 -5-85; designated effective 1-1-86 (Register 85, No. 45). For prior his- 
tory, see Register 83, No. 16. 

2. Amendment of subsection (b) filed 9-7-93; operative 10-6-93 (Register 93, 
No. 37). 

3. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to section 100, title 1, California Code of Regulations (Register 2000, No. 44). 

§ 97005. Definitions. 

As used in this Chapter: 

(a) "Act" means the Health Data and Advisory Council Consolidation 
Act set forth in Division 1, Part 1 .8 (commencing with Section 128675) 
of the Health and Safety Code. 



(b) ''Unrestricted funds" means funds which bear no external restric- 
tions as to use or purpose: i.e., funds which can be used for any legitimate 
purpose designated by the governing board as distinguished from funds 
restricted externally. 

(c) "Restricted funds" means funds restricted by donors or grantors for 
specific purposes. The term refers to plant replacement and expansion, 
specific purpose and endowment funds. 

(d) "Long-term care facility" and "long-term care facilities" mean all 
skilled nursing facilities, intermediate care facilifies, intermediate care 
facilities/developmentally disabled, and congregate living heath facili- 
ties licensed pursuant to Chapter 2 (commencing with Section 1250) of 
Division 2, Heath and Safety Code. 

(e) "Preponderance" means 51 percent or more of gross in-padent rev- 
enue. This definifion also applies to Section 128760 of the Health and 
Safety Code. 

(f) "Director" means the Director of the Office of Statewide Health 
Planning and Development. 

(g) "Health facility" or "health facilities" means all health facilifies 
required to be licensed pursuant to Chapter 2 (commencing with Secfion 
1 250) of Division 2 of the Health and Safety Code. 

(h) "Health facility gross operafing cost for the provision of health care 
services" (Secfion 127280(a), Health and Safety Code) means total pa- 
fient-related operating expenses as reported to the Office for the fiscal 
years ending on or before June 30 of the previous calendar year on: 

(1) Hospital disclosure report CHC 7041 d-1, column 1 , line 200, for 
hospitals, and 

(2) Long-term care facility disclosure report CHFC 7041 d-1 , column 
1 , line 200, for long-term care facilities. 

(i) "New health facility" means any health facility beginning or resum- 
ing operations for the first time within a 12-month period. 

(j) Disclosure reports, extension requests, appeal petitions, and other 
items are deemed to have been "filed" or "submitted" with the Office: 

(1) as of the date they are postmarked by the United States Postal Ser- 
vice if properly addressed and postage prepaid; 

(2) as of the date they are dated by a commercial carrier if properly ad- 
dressed and delivery fee prepaid; 

(3) when received by the Office via FAX machine or other electronic 
device; 

(4) when received by the Office via hand delivery; or 

(5) when otherwise received by the Office. 

(k) "Hospital accounfing manual," "manual for hospitals" and "hospi- 
tal manual" mean the "Accounfing & Reporting Manual for California 
Hospitals" published by the Office and more particularly described by 
Section 97018 of this Chapter. 

(/) "Long-term care manual," "manual for long-term care facilities," 
and "LTC manual" mean the "Accounting and Reporting Manual for 
California Long-term Care Facilities" published by the Office and more 
particularly described by Section 97019 of this Chapter. 

(m) "Owner" means any individual or organization having a five per- 
cent or more equity interest, direct or indirect, in the entity licensed as a 
health facility. 

(n) "Office" and "OSHPD" mean the Office of Statewide Health Plan- 
ning and Development. 

(o) "Commission" means the California Health Policy and Data Advi- 
sory Commission. 

(p) "Licensee" means the person, firm, partnership, association, cor- 
poration, political subdivision of the state, or other governmental agency 
within the state licensed to operate a health facility. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Part 
1.8 of Division 1 and Section 1253, Health and Safety Code. 

History 

1 . Change without regulatory effect of subsection (h) filed 1 1-28-88 (Register 88, 
No. 51). 

2. Amendment section and Note filed 9-7-93; operative 10-6-93 (Register 93, 
No. 37). 

3. Editorial correction of printing error in subsection (k) (Register 93, No. 51). 

4. Amendment of subsection (h)(2) filed 9-7-95; operative 10-7-95 (Register 95, 
No. 36). 

5. Change without regulatory effect amending subsections (a), (e) and (h) and 
amending Note filed 10-31-2000 pursuant to secfion 100, title 1, California 
Code of Regulations (Register 2000, No. 44). 



Page 1232 



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Title 22 



Health Planning and Facility Construction 



§ 97017 



§ 97007. Notice of Change in Health Facility Fiscal Year, 
Licensure, Name, Address, or Closure. 

(a) Each license of a health facility shall notify the Office in writing 
whenever the health facility fiscal year is changed. Notification shall be 
made within 30 days of such action by the health facility. The notice shall 
include the health facility name, street address, and both old and new fis- 
cal year ending dates. 

(b) Each licensee of a health facility shall notify the Office in writing 
within 30 days of the effective date of any change of licensee of the health 
facility. Such notice shall include the following, as apphcable: the old 
and new names of the health facility, the names of the former and new 
licensees, permanent or forwarding street and mailing addresses of the 
former and new licensees, old and new telephone numbers of the health 
facility, the telephone number of the former licensee if available to the 
new licensee, the telephone number of the new licensee, the names of the 
owners having a five percent or more interest in the health facility, the 
names of the chair and members of the governing body, and the name of 
the individual in charge of the day-to-day operation of the health facility. 

(c) Each licensee of a health facility shall notify the Office in writing 
within 30 days of any change in the name, or telephone number, or street 
and mailing addresses of the health facility. Such notice shall include the 
old and new names of the health facility and/or the old and new street and 
mailing addresses of the health facility, and old and new telephone num- 
bers. 

(d) Each licensee of a health facility shall notify the Office in writing 
within 30 days of any change in the owners having a five percent or more 
interest in the health facility, in the chair and members of the governing 
body, and in the individual in charge of the day-to-day operation of the 
health facility. 

(e) Each licensee of a health facility shall notify the Office in writing 
within 30 days of the facility's closure. Such notice shall include the last 
date patient care was provided, the final date of licensure, the street and 
mailing address of the health facility, the permanent or forwarding mail- 
ing address of the health facility licensee, the telephone number of the 
health facility licensee. 

(0 Each licensee of a hospital shall notify the Office in writing within 
30 days of the date the license is placed in suspense. Such notice shall 
include the last date patient care was provided, the date the license was 
placed in suspense, the street and mailing address of the health facility, 
the permanent or forwarding mailing address of the health facility licens- 
ee, and the telephone number of the health facility licensee. 
NOTE: Authority cited: Section f28810. Health and Safety Code. Reference: Sec- 
tions 127280, 128735, 128740, 128755 and 128760, Health and Safety Code. 

History 

1 . Amendment filed 3-25-91 ; operative 4-24-91 (Register 91. No. 16). 

2. Amendment filed 9-7-93; operative 10-6-93 (Register 93, No. 37). 

3. Editorial correction of printing error in subsections (b) and (f) (Register 93, No. 
51). 

4. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to section 100, title 1, California Code of Regulations (Register 2000, No. 44). 

§ 97008. Notice of New Health Facility Operations. 

Each licensee of a health facility beginning operations, whether in a 
newly constructed facility or in an existing facility, pursuant to a new li- 
cense or a license previously in suspense, shall provide the Office the fol- 
lowing information in writing within seven days after the effective date 
of the license: name of health facility, name of licensee, street and mail- 
ing addresses of the health facility and the licensee, telephone numbers 
of the health facility and the licensee including area codes, fiscal year 
ending date, date when first patients are expected to be admitted, names 
of the owners having a five percent or more interest in the health facility, 
names of the chair and members of the governing body, and name of the 
individual in charge of the day-to-day operation of the health facility. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 127280, 128735, 128740, 128755 and 128760, Health and Safety Code. 

History 

1. Amendment filed 9-7-93; operative 10-6-93 (Register 93, No. 37). 

2. Editorial correction of printing error (Register 93, No. 51). 

3. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to section 100, title 1 , California Code of Regulations (Register 2000, No. 44). 



Article 2. Accounting System 
Requirements 

§ 9701 5. Chart of Accounts. 

(a) All hospitals shall use in their books of account the Chart of Ac- 
counts set forth in the "Accounting and Reporting Manual for California 
Hospitals," as specified by section 97018, except as provided herein. If 
individual requirements for information make further breakdown of an 
account necessary, hospitals may use subaccounts provided they can be 
combined into the prescribed account framework for reporting purposes. 

(b) All long-term care facilities shall use in their books of account the 
Chart of Accounts set forth in the "Accounting and Reporting Manual for 
California Long-term Care Facilities" as specified by Section 9701 9, ex- 
cept as provided herein. If individual requirements for information make 
further breakdown of an account necessary, long-term care facilities 
may use subaccounts provided they can be combined into the prescribed 
account framework for reporting purposes. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128760, Health and Safety Code. 

History 

1. Renumbering and amendment of former title 4, chapter 10 (sections 
70 15-701 9) to title 22, division 7 (sections 97015-97019) filed 11-5-85; desig- 
nated effective 1 -1-86 (Register 85, No. 45). For prior history, see Register 83, 
No. 16. 

2. Amendment filed 3-25-91; operative 4-24-91 (Register 91, No. 16). 

3. Amendment of subsection (b) filed 9-7-93; operative 10-6-93 (Register 93, 
No. 37). 

4. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to secfion 100, title 1, California Code of Regulations (Register 2000, No. 44). 

§ 97016. Accrual Accounting. 

A full accrual basis of accounting for revenue and expenses is required 
for all health facilities. Revenues shall be given recognition in the period 
during which the service is provided. Except as may be provided in the 
long-term care manual prescribed by Section 97019, patient revenue 
shall be recorded at the full established rates regardless of the amounts 
actually paid to the health facility by or on behalf of the patients. Revenue 
deductions in all health facilities shall be given accounting recognition 
in the same period that the related revenues are recorded. Health facility 
expenses shall be given recognition in the period in which there is (1) a 
direct identification or association with the revenue of the period, as in 
the case of services rendered to patients; (2) an indirect association with 
revenue of the period, as in the case of salaries or rent; or (3) a measurable 
expiration of asset costs even though not associated with the production 
of revenue for the current period, as in the case of losses from fire. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128760, Health and Safety Code. 

History 

1 . Amendment filed 4-16-92; operative 5-18-92 (Register 92, No. 18). 

2. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to section 100, title 1, California Code of Regulations (Register 2000, No. 44). 

§ 97017. Special Accounting Requirements and Account 

Codes. 

(a) Health facilities shall segregate accounts between unrestricted 
funds and restricted funds. Within the restricted fund classification shall 
be such funds as specific purpose funds, endowment funds, plant replace- 
ment and expansion funds, and other special purpose funds. 

(b) All hospitals shall use in their books and records the account cod- 
ing structure specified in the "Accounting and Reporting Manual for Cal- 
ifornia Hospitals" as specified by Section 97018. 

(c) All long-term care facilities shall use in their books and records the 
account coding structure specified in the "Accounting and Reporting 
Manual for California Long-term Care Facilities," as specified by Sec- 
tion 97019. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128760, Health and Safety Code. 

History 

1. Amendment of subsection (c) filed 4-16-92; operative 5-18-92 (Register 92, 
No. 18). 

2. Amendment of subsection (b) filed 9-7-93; operative 10-6-93 (Register 93, 
No. 37). 



Page 1233 



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§ 97018 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



3. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to secltion 100, title 1 , California Code of Regulations (Register 2000, No. 44). 

§ 97018. Accounting and Reporting Manual for California 
Hospitals. 

(a) To as.sure uniformity of accounting and reporting procedures 
among California hospitals, the Office shall publish an "Accounting and 
Reporting Manual for California Hospitals," which shall be supplemen- 
tal to the system adopted by this Chapter. The "Accounting and Report- 
ing Manual for California Hospitals," Second Edition, amended July 26, 
2003, shall not be published in full in the California Code of Regulations, 
but is hereby incorporated by reference. All hospitals must comply with 
systems and procedures detailed in the hospital manual. Copies of the 
"Accounting and Reporting Manual for California Hospitals" may be ob- 
tained from the Office at 818 K Street, Room 400, Sacramento CA 
958 1 4. The Office shall provide each new hospital with a copy of the hos- 
pital manual. Tlie hospital manual published by the Office shall be the 
official and binding interpretations of accounting and reporting treat- 
ment within the hospital accounting and reporting system. 

(b) Requests for modifications to the accounting and reporting sys- 
tems as set forth by the hospital manual shall be filed as provided under 
Section 97050. 

NOTE: Authority cited: Section 12881 0, Health and Safety Code. Reference: Sec- 
tion 128760, Health and Safety Code. 

History 

1. Amendment of sections 2210.1, 2220.1, 2410.1 and 4020 of the "Accounting 
and Reporting Manual for California Hospitals" filed 8-7-86; effective thirtieth 
day thereafter (Register 86, No. 34). 

2. Amendment of subsection (a) and "Accounting and Reporting Manual for Cali- 
fornia Hospitals," section 2420.2 (7140, 7150 and 7160), and editorial correc- 
tion of subsections (b) and (c) filed 5-23-88; operative 6-22-88 (Reeister 88, 
No. 22). 

3. Amendment filed 3-25-91; operafive 4-24-91 (Register 91. No. 16). 

4. Editorial conection of subsection (a) and Note (Register 91 , No. 30). 

5. Amendment of subsection (a) and Accounting and Reporting Manual for Cali- 
fornia Hospitals — First Edition filed 8-6-92; operative 9-7-92 (Register 92, 
No. 32). 

6. Amendment of subsection (a) and Accounting and Reporting Manual for Cali- 
fornia Hospitals — Second Edition filed 8-6-92; operative 9-7-92 (Register 
92, No. 32). 

7. Amendment filed 9-7-93; operative 10-6-93 (Register 93, No. 37). 

8. Amendment of secfion and Accounting and Reporting for California Hospitals 
— Second Edition filed 9-28-93; operative 10-28-93 (Register 93, No. 40). 

9. Editorial correcfion filed 9-28-94 (Register 94, No. 39). 

10. Amendment of subsection (a) and Accounting and Reporting Manual for Cali- 
fornia Hospitals — Second Edition filed 9-29-94; operative 10-31-94 (Regis- 
ter 94, No. 39). 

11. Amendment of subsection (a) and Accounting and Reporting Manual for Cali- 
fornia Hospitals — Second Edition filed 3-1-95; operative 3-31-95 (Register 

95, No. 9). 

12. Amendment of subsection (a) and Accounfing and Reporting Manual for Cali- 
fornia Hospitals — Second Edition filed 9-27-95; operative 10-27-95 (Regis- 
ter 95, No. 39). 

13. Amendment of subsection (a) and Accounting and Reporting Manual for Cali- 
fornia Hospitals — Second Edition filed 1 1-5-96; operative 12-5-96 (Register 

96, No. 45). 

14. Editorial correction (Register 96, No. 50). 

15. Editorial correction (Register 97, No. 19). 

16. Amendment of subsecfion (a) and Note filed 9-22-98; operative 10-22-98 
(Register 98, No. 39). 

17. Amendment of subsecfion (a) and the Accounting and Reporting Manual for 
California Hospitals (incorporated by reference) filed 3-20-2000; operative 
4-19-2000. Submitted to OAL for prinfing only (Register 2000, No. 12). 

1 8. Amendment of ihc Accounting and Reporting Manual for California Hospitals 
(incorporated by reference) and amendment of section filed 6-26-2003; opera- 
tive 7-26-2003 (Register 2003, No. 26). 

§ 97019. Accounting and Reporting Manual for California 
Long-Term Care Facilities. 

(a) To assure uniformity of accounting and reporting procedures 
among long-term care facilities, the Office shall publish an "Accounting 
and Reporting Manual for California Long-term Care Facilities," which 
will be supplemental to the system adopted by this Chapter. The "Ac- 
counting and Reporting Manual for California Long-term Care Facili- 
ties," Second Edition (Manual) as amended November 30, 2000, shall 
not be published in full in the California Code of Regulations, but is here- 
by incorporated by reference. All long-term care facilities must comply 
with the systems and procedures detailed in the Manual. Copies of the 



Manual may be obtained from the Office at 818 K Street, Room 400, Sac- 
ramento, CA 95814. The Office shall provide each new long-term care 
facility with a copy of the "Accounting and Reporting Manual for Cali- 
fornia Long-term Care Facilities." The Manual published by the Office 
shall be the official and binding interpretations of accounting and report- 
ing treatment within the long-term care facility accounting and reporting 
system. 

(b) Requests for modifications to the accounting and reporting sys- 
tems as set forth by the Manual shall be filed as provided under Section 
97050. 

NOTE: Authority cited: Secfion 12881 0, Health and Safety Code. Reference: Sec- 
fion 128760, Health and Safety Code. 

History 

1 . Amendment of sections 2012, 2230 and 3230 of the "Accounfing and Reporting 
Manual for California Long-Term Care Facilifies" filed 7-28-86; effective 
thirtieth dav thereafter (Register 86, No. 31). 

2. Amendment of sections 1050, 1110,2210.1.2220.1,3210.1 and 3220.1 of the 
"Accounting and Reporting Manual for California Long-Term Care Facilities" 
filed 8-7-86; effecfive thirtieth day thereafter (Register 86, No. 34). 

3. Amendment of subsections (a) and (c) and secfions 1 050, 1 1 1 0, 22 10. 1 , 22 1 0.2, 
2220.1. 2220.4, 3210.1 , 3210.2, 3220.1 and 3220.4 of the "Accounfing and Re- 
porting Manual for California Long-Term Care Facilities" filed 11-15-88; op- 
erative 12-15-88 (Register 88, No. 47). 

4. Amendment of subsections (a) and (c) filed 4-16-92; operative 5-18-92 (Reg- 
ister 92, No. 18). 

5. Amendment filed 9-7-93; operative 10-6-93 (Register 93, No. 37). 

6. Editorial correction of prinfing errors (Register 93, No. 51). 

7. Amendment of subsecfion (a) and Accounting and Reporting Manual for Cali- 
fornia Long-term Care Facilifies — Second Edifion filed 9-29-94; operafive 
]0_31_94 (Register 94, No. 39). 

8. Amendment of subsecfion (a) and Accounting and Reporting Manual for Cali- 
fornia Lons-Term Care Facilities — Second Edifion filed 3-1-95; operafive 
3-31-95 (Register 95, No. 9). 

9. Amendment of subsection (a) and Accounfing and Reporting Manual for Cali- 
fornia Long-term Care Facilities — Second Edition (incorporated by reference) 
filed 9-7-95; operafive 10-7-95 (Register 95. No. 36). 

10. Amendment of subsecfion (a) and Accounting and Reporting Manual for Cali- 
fornia Long-Term Care Facilifies — Second Edifion (incorporated by reference) 
filed 7-22-96 as an emergency; operative 7-22-96 (Register 96, No. 30). A 
Certificate of Compliance must be transmitted to OAL by 1 1-19-96 or emer- 
gency language will be repealed by operation of law on the following day. 

1 1 . Amendment of subsection (a) and Accounfing and Reporting Manual for Cali- 
fornia Long-Term Care Facilities — Second Edition (incoi-porated by reference) 
filed 12-2-96 as an emergency; operative 12-2-96 (Register 96, No. 49). A 
Certificate of Compliance must be transmitted to OAL by 4-1-97 or emergency 
language will be repealed by operation of law on the following day. 

12. Amendment of subsection (a) and Accounfing and Reporting Manual for Cali- 
fornia Long-Term Care Facilities — Second Edifion (incorporated by reference) 
filed 12-1 1-96; operafive 1-10-97 (Register 96, No. 50). 

13. Editorial correcfion of History 10 (Register 96, No. 51). 

14. Certificate of Compliance as to 7-22-96 order transmitted to OAL 11-4-96 
and filed 12-17-96 (Register 96, No. 51). 

15. Certificate of Compliance as to 12-2-96 order transmitted to OAL 3-27-97 
and filed 5-8-97 (Register 97, No. 19). 

16. Amendment filed 10-1-98; operafive 10-31-98 (Register 98, No. 40). 

17. Amendment of subsection (a) filed 1 1-17-99; operafive 12-17-99 (Register 
99, No. 47). 

18. Change without regulatory effect amending subsection (a) filed 10-31-2000 
pursuant to section 100, fide 1, California Code of Regulafions (Register 2000, 
No. 44). 

§ 97020. Delayed Implementation of LTC Accounting 
Manual Second Edition. 

NOTE: Authority cited: Secfion 443.45, Health and Safety Code. Reference: Sec- 
tion 443.34, Health and Safety Code. 

History 

1. New section filed 4-16-92; operafive 5-18-92 (Register 92, No. 18). 

2. Editorial correction of prinfing error in Note (Register 93, No. 51). 

3. Repealer filed 10-1-98; operafive 10-31-98 (Register 98, No. 40). 

§ 97030. Failure to Meet Accounting Requirements. 

(a) If the Office determines either by routine desk audit, on-site audit, 
or other means that a health facility is not substantially using on a day-to- 
day basis in its books and records the system of accounting prescribed by 
this Article, considering all modifications granted by the Office pursuant 
to Section 97050 and the special accounting provisions provided to 
health facilities by this Chapter and the Act, then the health facility shall 
be considered to be out of compliance with the prescribed system of ac- 
counting. If such a determination is made, the Office shall begin the fol- 
lowing process: 



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Title 22 



Health Planning and Facility Construction 



§ 97041 



(1) The Office shall notify the licensee at the mailing address of the 
health facility of the determination of noncompliance and the licensee 
shall have 90 days in which to file the following in writing with the Of- 
fice: 

(A) A copy of the health facility's current Chart of Accounts with ac- 
count codes and titles certified by an official of the facility that it is the 
Chart of Accounts that is used on a day-to-day basis by the health facility 
and 

(B) A detailed plan of action for the health facility to come into full 
compliance with the Office's specified system of accounting, including 
the planned date of implementation. 

(2) The Office shall have 30 days from receipt of the Chart of Accounts 
and the plan of action required in (a)(1)(A) and (B) of this Section in 
which to review and respond in writing to the licensee regarding accep- 
tance or rejection of the filed Chart of Accounts and plan of action. 

(3) If the proposed plan of action is not approved by the Office, then 
the licensee shall be notified at the mailing address of the health facility 
that the licensee has a maximum of 30 days in which to file a revised plan 
of action. 

(4) The Office shall have 30 days from receipt of the revised plan of 
action in which to review and respond in writing to the licensee regarding 
the revised plan's approval. With approval, the Office shall include a 
modification consistent with the approved plan of action. 

(5) If the licensee fails to meet either of the deadlines established in 
(a)(1) or (a)(3), then the licensee shall be liable for a civil penalty, to be 
assessed and recovered in a civil action brought in the name of the people 
of the State of California by the Office, of one hundred dollars ($100) a 
day for each day either deadline is missed. For each determination of 
non-compliance described in this subsection, the total amount the health 
facility can be penalized is not to exceed five thousand dollars ($5,000). 
Within fifteen days after a penalty begins to accrue, the Office shall 
notify the licensee at the mailing address of the health facility of the pen- 
alty accrual and potential liability. The notification will include the li- 
censee's right to appeal the penalty pursuant to Section 97052. 

(b) After a health facility has been determined to be non-compliant 
and has failed to develop an approved plan of action to implement the pre- 
scribed system of accounting, the health facility shall be liable for a pen- 
alty of five thousand ($5,000) each time the health facility files a report 
pursuant to either Section 128735(a) through (e) or Section 128740 of the 
Health and Safety Code. Within fifteen days after each penalty is deter- 
mined, the Office shall notify the hcensee at the mailing address of the 
health facility of the potential liability. The notification will include the 
licensee's right to appeal the penalty pursuant to Section 97052. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128735, 128740, 128760 and 128770, Health and Safety Code. 

History 

1. New section filed 9-7-93; operative 10-6-93 (Register 93, No. 37). 

2. Change without regulatory effect amending subsection (b) and Note filed 
10-31-2000 pursuant to section 100, title 1, California Code of Regulations 
(Register 2000, No. 44). 



• 



Article 3. Reporting Requirements 

§ 97040. Required Annual Reports. 

(a) The licensee of each health facility, shall submit the following re- 
ports, except as provided in Section 97044, to the Office within four 
months after the end of each reporting period: 

(1) A balance sheet for the unrestricted (general) funds. 

(2) A balance sheet for the restricted funds. 

(3) A statement of changes in equity (fund balances) for both unre- 
stricted and restricted funds. 

(4) A statement of income and expense. 

(5) A statement of cash flows for the unrestricted funds. 

(6) A cost finding report. 

(7) A detailed statistical report. 

(8) That data required for Medi-Cal cost reimbursement pursuant to 
Section 14170 of the Welfare and Institutions Code (skilled nursing, in- 
termediate care and congregate living health facilities only). 



(9) A statement detailing patient revenue by payor and revenue center 
except, that hospitals authorized to report as a group pursuant to subdivi- 
sion (d) of section 128760 of the Health and Safety Code are not required 
to report by revenue center. 

(10) And such other reports and worksheets as the Office enacts 
through the regulation process to constitute accurate and sufficiently de- 
tailed statistical reports and to enable proper completion of the above re- 
ports as set forth in the Office's "Accounting and Reporting Manual for 
Cahfomia Hospitals," as specified in Section 97018, and the Office's 
"Accounting and Reporting Manual for California Long-Term Care Fa- 
cihties," as specified in Section 97019. 

(b) A reporting period ends: 

(1) at the close of the health facility's annual accounting period (fiscal 
year), 

(2) on the last day of patient care when the health facility no longer 
accepts patients, 

(3) on the last day of patient care at the old facility when the health fa- 
cility closes to relocate to a new facility, 

(4) on the last day of hcensure of the entity relinquishing the license 
when there is a change in licensee, or 

(5) on the last day of patient care when the license is placed in sus- 
pense. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128735 and 128740, Health and Safety Code. 

History 

1. Renumbering and amendment of former title 4, chapter 10 (sections 
7040-7045) to title 22, division 7 (sections 97040-97045) filed 1 1-5-85; desig- 
nated effective 1-1-86 (Register 85, No. 45). For prior history, see Register 83, 
No. 16. 

2. Amendment filed 3-25-91; operative 4-24-91 (Register 91, No. 16). 

3. Editorial correction of printing error in subsections (a), (b)(3) and (4) (Register 
91, No. 32). 

4. Amendment of subsections (a)(1), (a)(3) and (a)(10) filed 4-16-92; operafive 
5-18-92 (Register 92, No. 18). 

5. Amendment of section and Note filed 9-7-93; operafive 10-6-93 (Register 93, 
No. 37). 

6. Editorial correction of printing errors in subsecfions (a), (a)(8) and (a)(10) (Reg- 
ister 93, No. 51). 

7. Change without regulatory effect amending subsection (a)(9) and Note filed 
10-31-2000 pursuant to section 100, fitle 1, California Code of Regulations 
(Register 2000, No. 44). 

§ 97041 . Report Procedure. 

(a) Health facilities shall report to the Office on forms or other media 
prescribed by the Office. 

(1) Health facilities shall file the annual reports required by subsec- 
tions (a) through (e) of Section 128735, Health and Safety Code, with the 
Office in a standard electronic format as approved by the Office pursuant 
to subsection (4). Health facilities may file requests for modifications to 
this reporting requirement, as provided under Section 97050, where 
meeting this requirement would not be cost-effective for the facility. 

(2) Hospitals shall file the quarteriy reports required by Section 
128740, Health and Safety Code, with the Office in a standard electronic 
format using the Internet Hospital Quarterly Reporting System available 
on Office's internet web site at: www.oshpd.state.ca.us/ihqrs. Hospitals 
must have internet access and use Microsoft Internet Explorer version 5.0 
to use the Internet Hospital Quarterly Reporting System. Hospitals may 
file requests for modifications to this reporting requirement, as provided 
under Section 97050, where meeting this requirement would not be cost- 
effective for the hospital. 

(3) To meet the requirement of subsection (1), health facilities shall 
use a program approved pursuant to subsection (4), which can be either 
a third-party program or their own program. Health facilities intending 
to use a third-party program are not required to notify the Office of that 
intent. The Office shall notify all health facilities and third parties with 
Office-approved electronic reporting programs of any change in the 
electronic reporting requirements. The Office shall maintain and make 
available a list of all programs approved pursuant to subsection (4). 

(4) Programs to be used for filing reports in a standard electronic for- 
mat pursuant to subsection (1) must be approved by the Office in advance 
and must meet the Office's specifications for electronic reporting, in- 
cluding dial-up via personal computer and personal computer diskettes. 



Page 1235 



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§ 97042 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



To he approved, electronic reporting programs must be able to apply Of- 
fice-speci fled edits to the data being reported and must be able to produce 
a standardized output file that meets the Office's specified electronic for- 
mats. Specifications for submitting hospital annual reports in a standard 
electronic format shall be provided by the Office upon request and shall 
include file and record formats, editing criteria, and test case require- 
ments, as published by the Office in the July 2002 issue of "Instructions 
and Specifications for Developing Approved Software to Submit the Cal- 
ifornia Hospital Annual Disclosure Report on Personal Computer Dis- 
kette," and herein incorporated by reference in its entirety. Specifications 
for submitting LTC facility annual reports in a standard electronic format 
shall be provided by the Office upon request and shall include file and re- 
cord formats, editing criteria, and test case requirements, as published by 
the Office in the November 2001 issue of "Instructions and Specifica- 
tions for Developing Approved Software to Submit the California Long- 
term Care Facility Integrated Disclosure & Medi-Cal Cost Report on 
Personal Computer (PC) Diskette," and herein incorporated by reference 
in its entirety. To obtain approval for an electronic reporting program, a 
request, together with the Office's specified test case and a signed state- 
ment certifying that the program includes all Office-specified edits, must 
be filed with the Office at 818 K Street, Room 400, Sacramento, CA 
95814, at least 90 days prior to the end of the reporting period to which 
the program applies. The Office shall review the test case and respond 
within 60 days by either approving or disapproving the request. The Of- 
fice may Hmit the approval of the electronic reporting program to a speci- 
fied period of time or reporting period(s). If disapproved, the Office shall 
set forth the basis for a denial. The Office may seek additional informa- 
tion from the requestor in evaluating the request. Changes to the Office's 
electronic reporting specifications may require the programs used for fil- 
ing reports in a standard electronic format to be re-approved. 

(b) The Office shall develop forms and instructions related to their use, 
and related specifications for filing reports in an electronic format, and 
make such administrative revisions to the above items as may be neces- 
sary to assure uniform and appropriate reporting. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128680, 128730, 128735 and 128740, Health and Safety Code. 

History 

1 . New subsections (a)(l )-(4) and amendment of subsection (b) filed 9-7-93; op- 
erative 10-6-93 (Register 93, No. 37). 

2. Amendment of subsection (a)(4) filed 9-29-94; operative 10-31-94 (Register 
94, No. 39). 

3. Amendment of subsections (a)(1), (a)(2) and (a)(4) and amendment of Note 
filed 9-22-98; operative 10-22-98 (Register 98, No. 39). 

4. Amendment of subsections (a)(2) and (a)(4) filed 6-26-2003; operadve 
7-26-2003 (Register 2003, No. 26). 

§ 97042. Comparative Reports. 

Each health facility, except for new health facilities, shall include prior 
year comparative figures when reporting balance sheet-unrestricted 
funds, balance sheet-restricted funds, statement of cash flows-unres- 
tricted funds, and statement of income and expense. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. Amendment filed 9-7-93; operative 10-6-93 (Register 93, No. 37). 

2. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to section 100, title 1, California Code of Regulations (Register 2000, No. 44). 

§ 97043. Form of Authentication. 

Each health facility report as specified by Sections 128735(a) through 
(e) and Section 128740 of the Health and Safety Code will be accompa- 
nied by a statement of authentication signed by a duly authorized official 
of the health facility that certifies under penalty of perjury that, as appli- 
cable, the Office of Statewide Health Planning and Development's ac- 
counting and reporting system as set forth in either the Office's "Ac- 
counting and Reporting Manual for California Hospitals" or 
"Accounting and Reporting Manual for California Long-term Care Faci- 
lities" has been implemented by the health facility; that the data in the ac- 
companying report are based on the appropriate system; and that to the 
best of the official's knowledge and information, each statement and 
amount in the accompanying report is believed to be true and correct. 



NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128735, 128740 and 128760, Health and Safety Code; and Section 14107.4, 
Welfare and Institufions Code. 

History 

1. Amendment filed 9-7-93; operative 10-6-93 (Register 93, No. 37). 

2. Editorial correcfion of printing error (Register 93, No. 51). 

3. Change without regulatory effect amending section and Note filed 10-3 1 -2000 
pursuant to section 100, title 1, California Code of Regulations (Register 2000, 

No. 44). 

§ 97044. Exceptions to Required Reports. 

County hospitals and State health facilities not operating under an en- 
terprise system of accounting are not required to submit balance sheet 
statements, statement of changes in equity, or a statement of cash flows. 
However, all County and State health facilities are encouraged to move 
toward full compliance with all regulatory reporting requireiTients. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
fion 128735, Health and Safety Code. 

History 

1. Amendment filed 9-7-93; operative 10-6-93 (Register 93, No. 37). 

2. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to section 1 00, title 1 , California Code of RegulaUons (Register 2000, No. 44). 

§ 97045. Failure to File Required Reports. 

Any health facility which does not file with the Office any report com- 
pleted as required by this Article is liable for a civil penalty of one 
hundred dollars ($1 00) a day to be assessed and recovered in a civil action 
brought in the name of the people of the State of California by the Office 
for each day the filing of such report with the Office is delayed, consider- 
ing all approved extensions of the due date as provided in Section 9705 1 . 
Assessed penalties may be appealed pursuant to Section 97052. Within 
fifteen days after the date the reports are due, the Office shall notify the 
health facility of reports not yet received, the amount of liabihty, and po- 
tential future liability for failure to file said reports when due. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
fions 128770 and 128760, Health and Safety Code. 

History 

1. Amendment filed 9-7-93; operative 10-6-93 (Register 93, No. 37). 

2. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to section 100, title 1, California Code of Regulations (Register 2000, No. 44). 

3. Amendment of secfion and Note filed 9-23-2003; operative 9-23-2003 pur- 
suant to Government Code section 1 1343.4 (Register 2003, No. 39). 

Article 4. Modification, Extension, and 
Appeal Processes 

§ 97050. Request for Modifications to Approved 
Accounting and Reporting Systems. 

(a) To obtain modifications to the uniform accounting and reporting 
systems specified by Sections 970 17, 97018, and 97019, including modi- 
fications to the account coding structure, health facilities must file a writ- 
ten request for modifications with the Office. Health facihties must have 
an Office-approved modification prior to implementation of any change 
to the applicable uniform accounting systein. Modification requests shall 
specify the precise changes being requested and the reason(s) the 
changes are needed. Requests from health facilities for modification to 
the appUcable uniform accounting system, including requests to use an 
alternate coding scheme, shall be accompanied by (1) a cross reference 
between the facility's proposed account codes and titles, and the account 
codes and titles in the applicable accounting and reporting manual and 
(2) the facility's account definitions. The Office shall either approve or 
disapprove requests for modification within 60 days of the date the re- 
quest was filed with the Office by the health facility, or the request shall 
be considered approved as submitted. However, if additional informa- 
tion is required from the health facility to evaluate the request, the Office 
shall have 30 days from the receipt of the additional information to ap- 
prove or disapprove the request. The Office may also seek additional in- 
formation from other appropriate sources to evaluate the request. Ap- 
proved requests for systems modifications are subject to annual review 
and renewal by the Office. 



• 



• 



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Title 22 



Health Planning and Facility Construction 



§ 97053 



(b) The Office shall grant modifications upon written application to li- 
censed health facilities that are an integral part of a residential care com- 
plex to permit accounting and reporting for assets, liabilities, and equity 
for the entire residential care complex rather than require separate ac- 
counting and reporting for health care related assets, liabilities, and equi- 
ty. Requests for modifications under this paragraph shall be submitted 
prior to the start of the accounting period to which the modifications are 
to apply and shall specify the proposed balance sheet account related 
modifications. 

(c) The Office may grant modifications, upon written request, to li- 
censees operating and maintaining more than one physical plant on sepa- 
rate premises under a single consolidated hospital license, issued pur- 
suant to Health and Safety Code Section 1250.8, to file separate amiual 
disclosure reports and quarterly financial and utilization reports for each 
location. The Office may also grant modifications, upon written request, 
to licensees of hospitals to file annual disclosure reports and quarterly fi- 
nancial and utilization reports for their mental health or rehabilitation 
care operations separately from the rest of the hospital operations. Li- 
censees granted modifications under this paragraph shall be responsible 
for all regulatory requirements for each separate report. Separate exten- 
sion requests, filed under the provisions of Section 97051, shall be re- 
quired for each report, and penalties, assessed pursuant to Section 97045, 
shall be assessed on each delinquent report. 

(d) In determining what modifications will be granted to health facili- 
ties under (a) or (c), the Office may take into account, but not be limited 
to the following factors: 

(1 ) the data reported are comparable to data reported from other health 
facilities to the maximum extent feasible as determined by the Office; 

(2) the report substantially complies with the purposes of the Health 
Data and Advisory Council Consolidation Act; 

(3) the facility has considered and has a plan for the eventual or gradual 
implementation of the general accounting and reporting systems pre- 
scribed by the Office; and 

(4) the burden on the health facility to report otherwise required data 
is sufficiently great that the cost to the health facility of preparing these 
data would outweigh the benefit to the people of the State of California. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128760, Health and Safety Code. 

History 

1. Renumbering and amendment of former title 4, chapter 10 (sections 
7050-7052) to title 22, division 10 (sections 97050-97052) filed 1 1-5-85; des- 
ignated effective 1-1-86 (Register 85, No. 45). For prior history, see Register 
83, No. 16. 

2. Amendment of subsections (a) and (b) filed 4-16-92; operative 5-18-92 (Reg- 
ister 92, No. 1 8). 

3. Amendment filed 9-7-93; operative 10-6-93 (Register 93, No. 37). 

4. Editorial correction of printing error in subsection (b) (Register 93, No. 51). 

5. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to section 1 00, title 1 , California Code of Regulations (Register 2000, No. 44). 

§ 97051. Requests for Extension Time to File Required 
Reports. 

Any licensee of a health facility may file with the Office requests for 
reasonable extensions of time to file any or all of the reports required pur- 
suant to subdivisions (a) through (e) of Section 128735, Section 128740, 
or Section 128755, Health and Safety Code. Licensees of health facilities 
are encouraged to file extension requests as soon as it is apparent that the 
required reports will not be completed for submission on or before their 
due date. The requests for extension shall be supported by justification 
which may provide good and sufficient cause for the approval of the ex- 
tension requests. To provide the Office a basis to judge good and suffi- 
cient cause, the letter of jusfification shall include a factual statement in- 
dicating (1) the actions taken by the health facility to produce the 
disclosure reports by the required deadhne, (2) those factors which pre- 
vent completion of the reports by the deadline, and (3) those actions and 
the time (days) needed to accommodate those factors. 

The Office shall respond within 10 calendar days of receipt of the re- 
quest by either granting what the Office determines to be a reasonable ex- 



tension or disapproving the request. If disapproved, the Office shall set 
forth the basis for a denial in a notice sent by certified mail to the health 
facility. The Office may seek additional information from the requesting 
health facihty. The Office may grant extensions but not to exceed an ac- 
cumulated total, for all extensions and corrections, of 90 days for annual 
reports required by Section 97040 and 30 days for quarterly reports re- 
quired by Health and Safety Code Section 128740. A health facility 
which wishes to contest any decision of the Office shall have the right to 
appeal in accordance with the provisions of Section 97052. 

The civil penalty of one hundred dollars ($100) a day, provided for in 
Section 97045, shall commence the day after the report due date notwith- 
standing the filing of a petition to review the Office's denial of a request 
for an extension of time in which to file required reports or the filing of 
a request for an extension of time in which to file required reports. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128755 and 128770, Health and Safety Code. 

History 

1. Amendment filed 9-7-93; operative 10-6-93 (Register 93, No. 37). 

2. Change without regulatory effect amending section and NOTIE filed 1 0-3 1 -2000 
pursuant to section 100, fitle 1, California Code of Regulations (Register 2000, 
No. 44). 

§ 97052. Appeal Procedure. 

(a) Any health facility affected by any determination made under the 
Act by the Office may appeal the decision. This appeal shall be filed with 
the Office within 1 5 business days after the date the notice of the decision 
is received by the health facility and shall specifically describe the mat- 
ters which are disputed by the petitioner. 

(b) A hearing on an appeal shall, at the discretion of the Director, be 
held before any one of the following: 

(1 ) An employee of the Office appointed by the Director to act as hear- 
ing officer. 

(2) A hearing officer employed by the Office of Administrative Hear- 
ings. 

(3) A committee of the Commission chosen by the chairperson for this 

purpose. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128775, Health and Safety Code. 

History 

1 . Repealer and new secfion filed 4-9-87; effective thirtieth day thereafter (Regis- 
ter 87, No. 15). For prior history, see Register 85, No. 45. 

2. Editorial correction of printing error in subsecfion (a) (Register 91, No. 32). 

3. Amendment filed 9-7-93; operative 10-6-93 (Register 93, No. 37). 

4. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to section 100, title 1 , California Code of Regulations (Register 2000, No. 44). 

§ 97053. Conduct of Hearing. 

(a) The hearing, when conducted by an employee of the Office ap- 
pointed by the Director to serve as hearing officer or by a committee of 
the Commission, shall not be conducted according to technical rules re- 
lating to evidence and witnesses. Any relevant evidence shall be admitted 
if it is the sort of evidence on which responsible persons are accustomed 
to rely in the conduct of serious affairs. 

(b) When the hearing is conducted by an employee of the Office or by 
a committee of the Commission, the hearing shall be recorded by a tape 
recording, unless the appellant agrees to provide a certified shorthand re- 
porter at the appellant's expense. If the appellant provides a certified 
shorthand reporter, the original of the transcript shall be provided directly 
to the Office. 

(c) A copy of the tape recording or of the transcript, if made, shall be 
available to any person so requesting who has deposited with the Office 
an amount of money which the Director has determined to be sufficient 
to cover the costs of the copy of the tape recording or transcript. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128775, Health and Safety Code. 

History 

1. New section filed 4-9-87; effective thirtieth day thereafter (Register 87, No. 
15). 

2. Change without regulatory effect amending NOTE filed 10-31-2000 pursuant 
to section 100, title 1, California Code of Regulations (Register 2000, No. 44). 



Page 1236.1 



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§ 97054 



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Title 22 



§ 97054. Decision on Appeal. 

(a) The employee, hearing officer, or committee shall prepare a recom- 
mended decision which includes findings of fact and conclusions of law. 

(b) This proposed decision shall be presented to the Office for its con- 
sideration. 

(c) The Office may adopt the proposed decision, or reject it and decide 
the matter as described in paragraph 1 below. 

(1) If the Office does not adopt the proposed decision as presented, it 
will furnish a Notice of Rejection of Proposed Decision along with a copy 
of the proposed decision to appellant and, if applicable, appellant's au- 
thorized representative. The Office will provide appellant the opportuni- 
ty to present written arguments to the Office. The decision of the Office 
will be based on the record, including the hearing record, and such addi- 
tional information as is provided by the appellant. 

(d) The decision of the Office shall be in writing. It shall be made with- 
in 60 calendar days after the conclusion of the hearing and shall be final. 



NOTE; Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128775, Health and Safety Code. 

HrSTORY 

1 . New section filed 4-9-87; effective thirtieth day thereafter (Reeister 87, No. 
15). 

2. Change without regulatory effect amending NOTE filed 10-31-2000 pursuant 
to secition 100, titie'l, California Code of Regulations (Register 2000, No. 44). 



Article 5. Collection of Special Fees 

§ 97062. Notice of Assessment. 

The Office shall mail a notice of special fee assessment and a remit- 
tance advice form to each health facility immediately after the assess- 
ment rate is set by the Office. The remittance advice form shall be com- 
pleted by each health facility and returned to the Office with full payment 
of the special fee amount. 



[The next page is 1237.] 



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Register 2007, No. 32; 8-10-2007 



Title 22 



Health Planning and Facility Construction 



§ 97170 



• 



• 



NOTE: Authority cited: Sections 127150 and 128810, Health and Safety Code. 
Reference: Section 127280, Health and Safety Code. 

History 

1. Renumbering and amendment of former title 4, chapter 10 (sections 
7062-7065) to title 22. division 7 (sections 97062-97065) filed 1 1-5-85; desig- 
nated effective 1-1-86 (Register 85. No. 45). For prior history, see Register 83, 
No. 16. 

2. Amendment of section and Note filed 9-7-93; operative 1 0-6-93 (Register 93, 
No. 37). 

3. Change without regulatory effect amending Note fded 10-31-2000 pursuant 
to secTion 100, title 1 . California Code of Regulations (Register 2000, No. 44). 

§ 97063. Basis of Assessment. 

The basis of assessment is the total gross operating expenses obtained 
from the disclosure reports filed for the report period which ended on or 
before June 30 of the previous calendar year, as more particularly de- 
scribed in Section 97005(h). 

NOTE: Authority cited: Sections 127150 and 128810, Health and Safety Code. 
Reference: Section 127280, Health and Safety Code. 

History 

1 . Amendment of section and Note filed 9-7-93; operative 1 0-6-93 (Register 93, 
No. 37). 

2. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to secfion 100, title 1, California Code of Regulations (Register 2000, No. 44). 

§ 97064. Exceptions to the Basis of Assessment. 

(a) New health facilities which have no fiscal years ending on or before 
June 30 of the preceding calendar year are not liable for the special fee. 

(b) New health facilities which have a fiscal year ending during the 
twelve month period precedingandincluditig June 30of the previous cal- 
endar year but which is less than 12 months, shall be liable for the special 
fee based on the gross operating expenses of the partial fiscal year. 

(c) If a health facility does not have a fiscal year ending during the 
twelve month period preceding and including June 30 of the previous cal- 
endar year due to a change in licensee, the special fee shall be based on 
the gross operating expenses of the previous licensee's last completed 
fiscal year, expanded to 12 months if applicable. If the gross operating 
expenses of the previous licensee' s last fiscal year are not available to the 
current hcensee, the special fee shall be the last special fee paid by the 
previous licensee plus ten percent. The Office shall furnish the amount 
of the last special fee paid by the previous licensee upon request of the 
affected health facility. 

(d) If a health facility does not have a complete fiscal year ending dur- 
ing the twelve month period preceding and including June 30 of the pre- 
vious calendar year due to a change in licensee, the special fee shall be 
based on the gross operating expenses of the partial fiscal year expanded 
to 1 2 months. The partial fiscal year is those months from the start of 
health facility operations under the new licensee to the end of the fiscal 
year. 

(e) If a health facility does not have a complete fiscal year ending dur- 
ing the 12 month period preceding and including June 30 of the previous 
calendar year due to a change in fiscal year, the special fee shall be based 
on the gross operating expenses of the partial fiscal year expanded to 1 2 
months. The partial fiscal year is those months from the close of the last 
complete fiscal year to the end of the new partial fiscal year. 

(f) The Office shall determine the basis of assessment for special fee 
amounts due from health facilities in those circumstances not specifically 
covered above. 

NOTE: Authority cited: Sections 127150 and 128810, Health and Safety Code. 
Reference: Section 127280, Health and Safety Code. 

History 

1 . Amendment of section and Note filed 9-7-93; operative 10-6-93 (Register 93, 
No. 37). 

2. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to section 100, title 1 , California Code of Regulations (Register 2000, No. 44). 

§ 97065. Delinquent Special Fees. 

To enforce payment of delinquent special fees, the Office shall notify 
the State Department of Health Services not to issue a license and not to 
renew the existing hcense of the delinquent health facility until the spe- 
cial fees have been paid, pursuant to Section 127280, Health and Safety 



Code. A copy of the Office notice to the State Departinent of Health Ser- 
vices shall be sent to the delinquent health facility. 
NOTE: Authority cited: Sections 127150 and 128810, Health and Safety Code; and 
Section 1 1 1 52, Government Code. Reference: Section 127280, Health and Safety 
Code. 

History 
1 . Change without regulatory effect amending section and Note filed 10-3 1 -2000 

pursuant to section 100, title 1, California Code of Regulations (Register 2000, 

No. 44). 



Article 6. 



Public Availability of Disclosure 
Materials 



§ 971 1 0. Place and Time of Availability. 

Copies of available disclosure materials may be inspected by and co- 
pied for any person upon request during regular business hours at the Of- 
fice of Statewide Health Planning and Development in Sacramento. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128680 and 128765, Health and Safety Code. 

History 

1. Renumbering and amendment of former Title 4, Chapter 10 (Sections 7110, 
71 15 and 7125) to Title 22, Division 7 (Sections 971 10, 971 15 and 97125) filed 
1 1-5-85; designated effective 1-1-86 (Register 85, No. 45). For prior history, 
see Register 78, No. 40. 

2. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to section 100, title 1, California Code of Regulations (Register 2000, No. 44). 

§ 971 1 5. Manner of Requesting Disclosure Materials. 

(a) Requests for disclosure materials shall be filed in writing with the 
Office. A request shall contain sufficient information to enable the Office 
to determine what specific materials are being requested. 

(b) No disclosure materials shall be provided, except as may be specif- 
ically authorized by the Director, without prior payment of a fee suffi- 
cient to cover costs of production and provision of the materials. 
NOTE: Authority cited: Secfion 128810, Health and Safety Code. Reference: Sec- 
tions 128680 and 128765, Health and Safety Code. 

History 

1. Change without regulatory effect amending Note filed 10-31-2000 pursuant 
to section 100, fitle 1, California Code of Regulations (Register 2000, No. 44). 

§97125. Protection of Records. 

(a) No person may, without permission of the Office, remove from the 
Office any disclosure materials made available for inspection or copying. 

(b) Only photocopies of the original disclosure materials shall be 

available for public inspection except as authorized by the Director. 

NOTE: Authority cited: Section 128810. Health and Safety Code. Reference: Sec- 
tions 128680 and 128765, Health and Safety Code. 

History 
1. Change without regulatory effect amending NOTE filed 10-31-2000 pursuant 
to section 100, title 1, California Code of Regulations (Register 2000, No. 44). 

Article 7. CABG Data Reporting 
Requirements 

§ 97170. Definitions, as Used in this Article. 

(a) California CABG Outcomes Reporting Program (CCORP). 
California CABG Outcomes Reporting Program means the Office's pro- 
gram charged with collecting coronary artery bypass graft (CABG) sur- 
gery data and publishing reports on the risk-adjusted outcomes for the 
procedure. 

(b) Computer system date. Computer system date means the date that 
exists on the computer system used for data automation at the time of data 
entry. 

(c) Coronary artery bypass graft (CABG) surgery. CABG surgery 
means a procedure performed to bypass blockages or obstructions of the 
coronary arteries, and includes both isolated CABG surgeries and non- 
isolated CABG surgeries, as defined by Subsection (a)(2) of Section 
97174. 

(d) Days. Days are defined as calendar days unless otherwise speci- 
fied. 



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BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



(e) Designee. Designee means the person authorized by the Chief 
Executive Officer of the hospital to sign the CCORP Hospital Certifica- 
tion Form (OSH-CCORP 416 (New 10/02). 

(f) Discharge. A discharge means a person who was formally admitted 
to a hospital as an inpatient for observation, diagnosis, or treatment, with 
the expectation of remaining overnight or longer, and who is released 
from the hospital under one of the following circumstances: 

(1) is formally released Irom the care of the hospital and leaves the hos- 
pital, 

(2) transfers within the hospital from one type of care to another type 
of care, as defined in Section 97212 of Title 22 of the California Code of 
Regulations, or 

(3) has died. 

(g) Facihty identification number. Facility identification number 
means the unique six-digit number assigned to each hospital by the Of- 
fice, pursuant to Section 97210 of Title 22 of the California Code of Reg- 
ulations. 

(h) Licensee. Licensee means an entity that has been issued a license 
to operate a hospital, as defined in the Health and Safety Code Section 
128700. 

(i) Record. Record means the set of data elements required to be re- 
ported for each CABG surgery, as set forth in Section 971 74. 

(j) Report. Report means the collection of all required records filed by 
a hospital for a reporting period, pursuant to Section 97172. 

(k) Responsible surgeon. Responsible surgeon means the principle 
surgeon who performs a coronary artery bypass procedure. If a trainee 
performs this procedure, then the responsible surgeon is the physician re- 
sponsible for supervising this procedure performed by the trainee. In situ- 
ations in which a responsible surgeon cannot otherwise be determined, 
the responsible surgeon is the surgeon who bills for the coronary artery 
bypass procedure. 

NOTE; Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128745, Health and Safety Code. 

History 

1. New article 7 (sections 97170-97198) and section filed 4-29-2003; operative 
4-29-2003 pursuant to Government Code section 1 1343.4 (Register 2003, No. 
18). 

2. Amendment of subsections (t)-(f)(l) filed 2-2-2006; operative 3-4-2006 
(Register 2006, No. 5). 

§97172. Required Reporting. 

(a) A hospital where coronary artery bypass graft (CABG) surgery is 
performed shall file a report, as defined in Section 97005(j) of Title 22 
of the California Code of Regulations, semiannually with the Office. This 
Section shall not apply to a hospital where all CABG surgeries performed 
are on patients under 18 years of age on the date of surgery. 

(b) A report shall contain a record for each CABG surgery padent 1 8 
years or older on the date of surgery who was discharged from the hospi- 
tal during the reporting period, pursuant to Section 97176. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128745, Health and Safety Code. 

History 

1. New section filed 4-29-2003; operative 4-29-2003 pursuant to Government 
Code secfion 1 1343.4 (Register 2003, No. 18). 

2. Amendment of subsection (a) filed 2-2-2006; operative 3-4-2006 (Register 
2006, No. 5). 

§ 97174. Required Data Elements. 

(a) A hospital shall submit the following data elements for each CABG 
surgery according to the format, valid value, and definitions/descriptions 
listed herein: 

(1) Medical Record Number: 

(A) Format: Text (alphanumeric) 

(B) Valid Values: Free text 

(C) Definition/Description: Patient medical record number at the hos- 
pital where surgery was performed. 

(2) Isolated CABG: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 



(C) Definition/Description: Answer 'No' if any of the procedures 
listed in Subsection (a)(2)(C)(i) was performed during coronary aitery 
bypass graft surgery. 

(i) When any of the procedures listed in this Subsection is performed 
concurrently with the coronary artery bypass surgery, the surgery will be 
considered non-isolated and the data eleinent coded 'No.' It is not pos- 
sible to list all procedures because cases can be complex and clinical defi- 
nitions are not always precise. When in doubt, the data abstractor should 
first seek an opinion from the responsible surgeon and then consult 
CCORP. 

(a) Valve repairs or replacements 

(b) Operations on structures adjacent to heart valves (papillary muscle, 
chordae tendineae, traebeculae carneae cordis, annuloplasty, infundibu- 
lectomy) 

(c) Ventriculectomy 

(d) Repair of atrial and ventricular septa, excluding closure of patent 
foramen ovale 

(e) Excision of aneurysm of heart 

(f) Head and neck, intracranial endarterectomy 

(g) Other open heart surgeries, such as aortic arch repair, pulmonary 
endarterectomy 

(h) Endarterectomy of aorta 

(i) Thoracic endarterectomy (endarterectomy on an artery outside the 
heart) 

(j) Heart transplantation 

(k) Repair of certain congenital cardiac anomalies, excluding closure 
of patent foramen ovale (e.g., tetralology of fallot, atrial septal defect 
(ASD), ventricular septal defect (VSD), valvular abnormality) 

(/) Implantation of cardiomyostimulation system (Note: Refers to car- 
diomyoplasty systems only; not other heart-assist systems such as pace- 
makers or internal cardiac defibrillators) 

(m) Any aortic aneurysm repair (abdominal or thoracic) 

(n) Aorta-subclavian-carotid bypass 

(o) Aorta-renal bypass 

(p) Aorta-iliac-femoral bypass 

(q) Caval-pulmonary artery anastomosis 

(r) Extracranial-intracranial (EC-IC) vascular bypass 

(s) Coronary artery fistula 

(t) Full surgical Maze procedures, surgical or catheter. Requires that 
the left atrium be opened to create the 'maze' with incisions. Does not 
include "mini" Maze procedures limited to pulmonary vein isolation and/ 
or amputation of the left atrial appendage. 

(u) Resection of a lobe or segment of the lung (e.g., lobectomy or seg- 
mental resection of lung). Does not include simple biopsy of lung nodule 
in which surrounding lung is not resected, biopsy of a thoracic lymph 
node, or excision or stapling of an emphysematous bleb. 

(v) Mastectomy for breast cancer (not simple breast biopsy) 

(w) Amputation of any extremity (e.g., foot or toe) 

(ii) If a procedure listed in this subsection is performed concurrently 
with the coronary artery bypass surgery, the surgery will be considered 
an isolated CABG and the data element coded 'Yes,' unless a procedure 
listed in Subsection (a)(2)(C)(i) is performed during the same surgery. 
These particular procedures are listed because the Office has received 
frequent questions regarding their coding. 

(a) Transmyocardial laser revascularization (TMR) 

(b) Pericardiectomy and excision of lesions of heart 

(c) Repair/restoration of the heart or pericardium 

(d) Coronary endarterectomy 

(e) Pacemakers 

(f) Internal cardiac defibrillators (ICDs) 

(g) Fem-fem cardiopulmonary bypass (a form of cardiopulmonary 
bypass that should not be confused with aortofemoral bypass surgery 
listed in Subsection (a)(2)(C)(i)) 

(h) Thymectomy 
(i) Thyroidectomy 
(3) Date of Surgery: 



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Title 22 



Health Planning and Facility Construction 



§ 97174 



(A) Format: Date (mm/dd/yyyy) 

(B) Valid Values: Between admission and computer system date 

(C) Definition/Description: Patient date of surgery for the CABG pro- 
cedure. 

(4) Date of Birth: 

(A) Format: Date (mm/dd/yyyy) 

(B) Valid Values: Before computer system date 

(C) Definition/Description: Patient date of birth. 

(5) Patient Age: 

(A) Format: Integer 

(B) Valid Values: calculated by hospital 

(C) Definition/Description: Patient age in years, at time of surgery. 
This should be calculated from the Date of Birth and the Date of Surgery, 
according to convention used in the USA (the number of birth date anni- 
versaries reached by the date of surgery). 

(6) Gender: 

(A) Format: Text (alpha) 

(B) Vahd Values: Male; Female 

(C) Definition/Description: Patient gender at birth. Gender must be 
present for Risk Models to activate. 

(7) Race: 

(A) Format: Text (alpha) 

(B) Valid Values: Caucasian; Black; Hispanic; Asian; Native Ameri- 
can; Other 

(C) Definition/Description: Patient race or ethnicity as determined by 
the patient or family. 

(8) Date of Discharge: 

(A) Format: Date (mm/dd/yyyy) 

(B) Valid Values: Between surgery and computer system date 

(C) Definition/Description: Patient date of discharge. If the patient 
died in the hospital, the discharge date is the date of death. 

(9) Discharge Status: 

(A) Format: Text (alpha) 

(B) Valid Values: Alive; Dead 

(C) Definition/Description: Patient status upon discharge from the 
hospitalization in which surgery occurred. 

(10) Date of Death: 

(A) Format: Date (mm/dd/yyyy) 

(B) Valid Values: Date of discharge or between date of discharge and 
computer system date 

(C) Definition/Description: Patient date of death. 

(11) Responsible Surgeon Name (3 separate fields): 

(A) Format: Surgeon Last Name text (alpha) 
Surgeon First Name text (alpha) 

Surgeon Middle Initial (alpha) 

(B) Valid Values: Free Text. 

(C) Definition/Description: The responsible surgeon is the surgeon as 
defined in Section 97170. 

(12) Responsible Surgeon California License Number: 

(A) Format: Text (alphanumeric) 

(B) Valid Values: Free text 

(C) Definition/Description: California physician license number of re- 
sponsible surgeon, assigned by the Medical Board of California of the 
Department of Consumer Affairs. 

(13) Height (cm): 

(A) Format: Numeric 

(B) Valid Values: 20.0 - 251.0 cm 

(C) Definition/Description: Height of the patient in centimeters. 

(14) Weight (kg): 

(A) Format: Numeric 

(B) Valid Values: 10.0 - 250.0 kg 

(C) Definition/Description: Weight of the patient in kilograms. 

(15) Diabetes: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 



(C) Definition/Description: The patient has a history of diabetes, re- 
gardless of duration of disease or need for anti-diabetic agents. Includes 
on-admission or preoperative diagnosis. Does not include gestational 
diabetes. 

(16) Hypertension: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: The patient has a diagnosis of hyperten- 
sion, documented by one of the following: 

(i) Documented history of hypertension diagnosed and treated with 
medication, diet and/or exercise. 

(ii) Blood pressure > 140 systolic or > 90 diastolic on at least 2 occa- 
sions. 

(iii) Currently on antihypertensive medication. 

(17) Peripheral Vascular Disease: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: The patient has a history at any time prior 
to surgery of Peripheral Vascular Disease, as indicated by claudication 
either with exertion or rest; amputation for arterial insufficiency; aorto- 
iliac occlusive disease reconstruction; peripheral vascular bypass sur- 
gery, angioplasty, or stent; documented abdominal aortic aneurysm 
(AAA), AAA repair, or stent; positive non-invasive testing documented. 
Does not include procedures such as vein stripping, carotid disease, or 
procedures originating above the diaphragm. 

(18) Cerebrovascular Disease: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: The patient has a history at any time prior 
to surgery of Cerebrovascular Disease, documented by any one of the fol- 
lowing: unresponsive coma > 24 hours; cerebrovascular accident (CVA) 
(symptoms > 72 hours after onset); reversible ischemic neurological def- 
icit (RIND) (recovery within 72 hours of onset); transient ischemic attack 
(TIA) (recovery within 24 hours of onset); non-invasive carotid test with 
> 75% occlusion; or prior carotid surgery. Does not include neurological 
disease processes such as metabolic and/or anoxic ischemic encephalo- 
pathy. 

(19) Cerebrovascular Accident: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: Has a history, at any time prior to surgery, 
of a central neurologic deficit persisting more than 72 hours, (i.e. extrem- 
ity weakness or loss of motion, loss of consciousness, loss of speech, field 
cuts). Chart documentation of a prior diagnosis of CVA or stroke is suffi- 
cient. 

(20) Cerebrovascular Accident Timing: 

(A) Format: Text (alphanumeric) 

(B) Valid Values: Recent (<=2 wk.); Remote (>2 wk.) 

(C) Definition/Description: Events occurring within two weeks of the 
surgical procedure are considered recent (<=2 wk.); all others are consid- 
ered remote (>2 wk.). 

(i) Recent (<=2 wk.) 
(ii) Remote (>2 wk.) 

(21) Chronic Lung Disease: 

(A) Format: Text (alpha) 

(B) Valid Values: No; Mild; Moderate; Severe 

(C) Definifion/Description: If the patient has chronic lung disease, the 
severity level according to the following classificafion is: 

(i) No: No chronic lung disease present. 

(ii) Mild: Forced expiratory volume in one second (FEVl) 60% to 
75% of predicted, and/or on chronic inhaled or oral bronchodilator thera- 

py- 

(iii) Moderate: FEVl 50-59% of predicted, and/or on chronic steroid 
therapy aimed at lung disease. 



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§ 97174 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



(iv) Severe: FEV 1 <50% predicted, and/or room air partial pressure of 
exygen (p02) <60 or room air partial pressure of carbon dioxide (pC02) 
>50. 

(22) Immunosuppressive Treatment: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: Patient has used any form of immuno- 
suppressive therapy (i.e., systemic steroid therapy) within 30 days pre- 
ceding the operative procedure. Does not include topical applications 
and inhalers or one time systemic therapy. 

(23) Hepatic Failure: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: The patient has cin-hosis or other liver dis- 
ease and has a bilirubin greater than 2mg/dl and a serum albumin less 
than 3.5 grams/dl. 

(24) Dialysis: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: The patient is currently undergoing dialy- 
sis. 

(25) Last Creatinine Level Preop (mg/dl): 

(A) Format: Numeric 

(B) Valid Values: O.J -30.0 

(C) Definition/Description: The most recent creatinine level prior to 
day of surgery. A creatinine level should be collected on all patients for 
consistency, even if they have no prior history. A creatinine value is a 
high predictor of a patient's outcome and is used in the predicted risk 
models. 

(26) Left Main Disease (% Stenosis): 

(A) Format: Integer 

(B) Valid Values: - 100 

(C) Definition/Description: Percentage of compromise of vessel di- 
ameter in any angiographic view. 

(27) Number of Diseased Coronary Vessels: 

(A) Format: Text (alpha) 

(B) Valid Values: None; One; Two; Three 

(C) Definition/Description: The number of major coronary vessel sys- 
tems (Left anterior descending (LAD) system, Circumflex system, and/ 
or Right system) with >=50% narrowing in any angiographic view. 
NOTE: Left main disease (>=50%) is counted as TWO vessels (LAD and 
Circumflex). For example, left main and right coronary artery (RCA) 
would count as three total. 

(28) Mitral Insufficiency: 

(A) Format: Text (alpha) 

(B) Valid Values: None; Trivial; Mild; Moderate; Severe 

(C) Definition/Description: Whether there is evidence of mitral valve 
regurgitation. 

(29) Ejection Fraction Done: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Indicate whether the Ejection Fraction was measured prior to the 
induction of anesthesia. 

(30) Ejection Fraction (%): 

(A) Format: Integer 

(B) Valid Values: 1-99 

(C) Definition/Description: The percentage of blood emptied from the 
ventricle at the end of the contraction. Use the most recent determination 
prior to intervention. 

(31) Ejection Fraction Method: 

(A) Format: Text (alpha) 

(B) Valid Values: LV Gram; Radionucleotide; Estimate; ECHO 

(C) Definition/Description: Method of obtaining ejection fraction 
measurement information: 

(i) LV Gram: Left Ventriculogram. 
Radionucleotide: MUGA Scan. 



(ii) Estimate: From other calculations, based upon available clinical 
data. 

(iii) ECHO: Echocardiogram. 

(32) Myocardial Infarction: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: Refers to any myocardial infarction (MI) 
in the past. For Mis prior to the current hospitalization for which detailed 
records are not available, chart documentation in which a clinician caring 
for the patient diagnosed an MI is sufficient. For Mis during the current 
hospitalization for which detailed records are available, conditions i and 
ii below must be met: 

(i) The patient must have been diagnosed with a myocardial infarction 
(ST elevation or non ST elevation) by a clinician caring for patient. 

(ii) At least 1 of the 3 following biochemical indicators for detecting 
myocardial necrosis must be present: 

(a) Troponin Tori: 

( 1 ) Maximal concentration of troponin T or I exceeding the MI diag- 
nostic limit (99th percentile of the values for a reference control group, 
as defined in Subsection (32)(C)(iii)) on at least one occasion during the 
first 24 hours after the index clinical event. 

(b)CK-MB: 

(1 ) Maximal value of CK-MB more than two times the upper limit of 
normal on at least one occasion during the first 24 hours after the index 
clinical event. 

(2) Maximal value of CK-MB, preferable CK-MB mass, exceeding 
99th percentile of the values for a reference control group, as defined in 
Subsection (32)(C)(iii), on two successive samples during the first 24 
hours after the index clinical event. 

(c) Total CK: 

(1) In the absence of availability of a troponin or CK-MB assay, total 
CK more than two Umes the upper limit of normal (99th percentile of the 
values for a reference control group, as defined in Subsection 
(32)(C)(iii)), or the B fraction of CK may be employed, but these last two 
biomarkers are considerably less satisfactory than CK-MB. 

(iii) Reference control values (MI diagnostic limit and upper limit of 
normal): 

(a) Reference values must be determined in each laboratory by studies 
using specific assays with appropriate quality control, as reported in 
peer-reviewed journals. Acceptable imprecision (coefficient of varia- 
tion) at the 99th percentile for each assay should be defined as less than 
or equal to 10 percent. Each individual laboratory should confirm the 
range of reference values in their specific setfing. 

(33) Myocardial Infarction Timing: 

(A) Format: Text (alphanumeric) 

(B) Valid Values: <=6 Hrs; >6 Hrs but <24 Hrs; 1- to 7 Days; 8- to 
21 Days;>21 Days. 

(C) Definition/Description: Time period between the last documented 
myocardial infarction and the CABG surgery in hours (Hrs) and days. 

(34) Arrhythmia: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: Whether there is a history of preoperative 
arrhythmia (sustained ventricular tachycardia, ventricular fibrillafion, 
atrial fibrillation, atrial flutter, third degree heart block) that has been 
clinically documented or treated with any of the following treatment mo- 
dalides within two weeks prior to the CABG surgery: 

(i) Ablafion therapy 

(ii) AICD 

(iii) Pacemaker 

(iv) Pharmachological treatment 

(v) Electrocardio version 

(35) Arrhythmia Type: 

(A) Format: Text (alpha) 

(B) Valid Values: Sust VTA^F; Heart Block; AFib/Flutter; None 



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(C) Definition/Description: The type of arrhythmia present within two 
weeks prior to the procedure is: 

(i) Sustained Ventricular Tachycardia or Ventricular Fibrillation re- 
quiring cardioversion and/or intravenous amiodarone. 

(ii) Third degree Heart Block. 

(iii) Atrial fibrillation/flutter requiring medication. 

(iv) None. 

(36) Cardiogenic Shock: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: The patient, at the time of procedure, is in 
a clinical state of hypoperfusion according to either of the following cri- 
teria: 

(i) Systolic blood pressure (BP) < 80 and/or Cardiac Index (CI) < 1.8 
despite maximnal treatment. 

(ii) Intravenous inotropes and/or intra-aortic balloon pump (lABP) 
necessary to maintain Systolic BP > 80 and/or CI > 1.8. 

(37) Angina: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: The patient has ever had angina pectoris. 

(38) Angina Type: 

(A) Format: Text (alpha) 

(B) Valid Values: Stable; Unstable 

(C) Definition/Description: The type of angina present within 24 
hours prior to the CABG surgery is: 

(i) Stable: Angina not meeting unstable criteria below that is con- 
trolled by oral or transcutaneous medication. 

(ii) Unstable: Requires continuous hospitalization from the episode 
until surgery and one of the following: 

(a) Angina at rest. 

(b) New onset angina in past 2 months of at least Canadian Cardiovas- 
cular Society (CCS) Class III. 

(c) Increasing angina in past 2 months — angina that has become more 
frequent, longer in duration, or lower in threshold; and increased by 
greater than or equal to 1 CCS class to at least CCS Class III severity. 

(39) Congestive Heart Failure: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: Indicate whether, within two weeks prior 
to the initial surgical procedure, a physician diagnosed that the patient is 
currently in congestive heart failure (CHF). CHF can be diagnosed based 
on careful history and physical exam, or by one of the following criteria: 

(i) Paroxysmal nocturnal dyspnea (PND). 

(ii) Dyspnea on exertion (DOE) due to heart failure. 

(iii) Chest X-Ray (CXR) showing pulmonary congestion. 

(iv) Pedal edema or dyspnea and receiving diuretics or digoxin. 

(40) NYHA Classification: 

(A) Format: Text (alpha) 

(B) Valid Values: Class I; Class II; Class III; Class IV 

(C) Definition/Description: New York Heart Association (NYHA) 
Classification represents the overall functional status of the patient in 
relationship to both congestive heart failure and angina. Code the highest 
level leading to episode of hospitalization and/or procedure. 

(i) Class I = Patients with cardiac disease but without resulting Hmita- 
tion of physical activity. Ordinary physical activity does not cause undue 
fatigue, palpitation, dyspnea or anginal pain. 

(ii) Class II = Patients with cardiac disease resulting in slight limitation 
of physical activity. They are comfortable at rest. Ordinary physical ac- 
tivity results in fatigue, palpitations, dyspnea or anginal pain. 

(iii) Class III = Patients with cardiac disease resulting in marked li- 
mitation of physical activity. They are comfortable at rest. Less than ordi- 
nary physical activity results in fatigue, palpitations, dyspnea, or anginal 
pain. 

(iv) Class IV = Patients with cardiac disease resulting in inability to 
carry on any physical activity without discomfort. Symptoms of cardiac 



insufficiency or of the anginal syndrome may be present even at rest. If 
any physical activity is undertaken, discomfort is increased. 

(41) Resuscitation 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: Indicate whether the patient required car- 
diopulmonary resuscitation within one hour before the start of the opera- 
tive procedure. 

(42) Incidence 

(A) Format: Text (alpha) 

(B) Valid Values: First cardiovascular surgery; First re-op cardiovas- 
cular surgery; Second re-op cardiovascular surgery; Third re-op cardio- 
vascular surgery; Fourth or more re-op cardiovascular surgery 

(C) Definition/Description: Whether this is the patient's: 
(i) First cardiovascular surgery 

(ii) First re-op cardiovascular surgery 

(iii) Second re-op cardiovascular surgery 

(iv) Third re-op cardiovascular surgery 

(v) Fourth or more re-op cardiovascular surgery 

(43) Previous CABG 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: Indicate whether the patient had a pre- 
vious Coronary Bypass Graft prior to the current admission. 

(44) Prior Percutaneous Coronary Intervention (PCI): 

(A) Format: Text (alpha) 

(B) Vahd Values: Yes; No 

(C) Definition/Description: Indicate whether a previous Percutaneous 
Cardie Intervention (PCI) was performed any time prior to this surgical 
procedure. PCI refers to those treatment procedures that unblock nar- 
rowed coronary arteries without performing surgery. PCI may include, 
but is not hmited to: 

(i) Balloon Catheter Angioplasty, Percutaneous Transluminal Coro- 
nary Angioplasty (PTCA) 
(ii) Rotational Atherectomy 
(iii) Directional Atherectomy 
(iv) Extraction Atherectomy 
(v) Laser Atherectomy 
(vi) Intracoronary Stent Placement 

(45) PCI Interval: 

(A) Format: Text (alphanumeric) 

(B) Valid Values: <=6 Hours; >6 Hours 

(C) Definition/Description: The interval of time between the previous 
PCI and the current surgical procedure: 

(i) <=6 Hours 
(ii) >6 Hours 

(46) Status of the Procedure: 
(A) Format: Text (alpha) 

(6) Valid Values: Emergent Salvage; Emergent; Urgent; Elective 

(C) Definition/Description: The status that best describes the cUnical 
status of the patient at the time of surgery. 

(i) Emergent Salvage: The patient is undergoing cardiopulmonary re- 
suscitation en route to the operating room or prior to anesthesia induc- 
tion. 

(ii) Emergent: The patient's clinical status includes any of the follow- 
ing: 

(b) Ischemic dysfunction (any of the following): 

(2) Ongoing ischemia including rest angina despite maximal medical 
therapy (medical and/or intra-aortic balloon pump (lABP)); 

(3) Acute evolving Myocardial Infarction within 24 hours before sur- 
gery; or 

(4) Pulmonary edema requiring intubation. 

(b) Mechanical dysfunction (either of the following): 

(1) Shock with circulatory support; or 

(2) Shock without circulatory support. 

(iii) Urgent: ALL of the following conditions are met: 



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Title 22 



(a) Not eleciive status 

(b) Not emergent status 

(c) Procedure required during same hospitalization in order to mini- 
mize chance of further clinical deterioration. 

(d) Worsening, sudden chest pain; congestive heart failure (CHF); 
acute myocardial infarction (AMI); coronary anatomy; lABP; unstable 
angina (USA) with intravenous nitroglycerin; rest angina, valve dysfunc- 
tion; or aortic dissection. 

(iv) Elective: The patient's status has been stable in the days or weeks 
prior to the operation. The procedure could be deferred without increased 
risk of compromised cardiac outcome. 

(47) CPB Utilization: 

(A) Format: Text (alpha) 

(B) Valid Values: None; Combination; Full 

(C) Definition/Description: Indicate the level of CPB or coronary per- 
fusion used during the procedure. 

(i) None: no CPB or coronary perfusion used during the procedure 

(ii) Combination: 

Either a, b, or c has to occur: 

(a) At start of procedure: No CPB/No coronary perfusion; followed by 
CPB 

(b) At start of procedure: No CPB/No coronary perfusion; followed by 
coronary perfusion 

(c) At start of procedure: No CPB/No coronary perfusion; followed by 
coronary perfusion; then convert to CPB 

(ii) Full: CPB or coronary perfusion was used for the entire procedure. 

(48) CPB Utilization-Combination: 

(A) Format: Text (alpha) 

(B) Valid Values: Planned; Unplanned 

(C) Definition/Description: Whether the combination procedure was 
a planned or an unplanned conversion 

(i) Planned: the surgeon intended to treat with any of the combination 
options described in "CPB utilization" 

(ii) Unplanned: the surgeon did not intend to treat with any of the com- 
bination options described in "CPB utilization". 

(49) Cardioplegia: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: Cardioplegia was used. 

(50) Internal Mammary Artery(ies) Used as Grafts: 

(A) Format: Text (alpha) 

(B) Valid Values: Left IMA; Right IMA; Both IMAs; No IMA 

(C) Definition/Description: Internal Mammary Artery(ies) (IMA) 
used for grafts, if any. 

(i) Left IMA 
(ii) Right IMA 
(iii) Both IMAs 
(iv) No IMA 

(51) Radial Artery Used: 

(A) Format: Text (alpha) 

(B) Valid Values: No Radial; Left Radial; Right Radial; Both Radials 

(C) Definition/Description: Indicate which radial artery(ies) was/were 
used for grafts: 

(i) No radial artery 
(ii) Left Radial artery 
(iii) Right Radial artery 
(iv) Both Radial arteries 

(52) Reoperation for Bleed/Tamponade: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: Whether an operative re-intervention was 
required for bleeding/tamponade. 

(53) Reoperation for Graft Occlusion: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 



(C) Definition/Description: Whether an operative re-intervention was 
required for coronary graft occlusion. 

(54) Deep Sternal Wound Infection 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: Indicate whether patient had a deep ster- 
nal infection involving muscle, bone, and/or mediastinum REQUIRING 
OPERATIVE INTERVENTION that met ALL the following conditions: 

(i) Wound was opened with excision of tissue (I&D) or re-exploration 
of mediastinum 
(ii) Positive culture 
(iii) Treatment with antibiotics 

(55) Postoperative Stroke >72 hours: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: A central neurologic deficit persisting 
postoperatively for more than 72 hours. 

(56) Continuous Coma >=24 hours: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: A new postoperative coma that persists 
for at least 24 hours secondary to anoxic/ischemic and/or metabolic ence- 
phalopathy, thromboembolic event or cerebral bleed. 

(57) Prolonged Ventilation: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: Pulmonary insufficiency requiring a ven- 
tilator. Include (but not limited to) causes such as ARDS and pulmonary 
edema; also include any patient requiring mechanical ventilation for 
more than 24 hours postoperatively. 

(58) Postoperative Renal Failure: 

(A) Format: Text (alpha) 

(B) Valid Values: Yes; No 

(C) Definition/Description: Acute or worsening renal failure resulting 
in one or more of the following: 

(i) Increase of serum creatinine to > 2.0 and 2x most recent preopera- 
tive creatinine level. 

(ii) A new requirement of dialysis postoperatively. 

(59) Facility Identification Number: 

(A) Format: Text (numeric) 

(B) Valid Values: Free Text 

(C) Definition/Description: The six-digit facility identification num- 
ber assigned by the Office, as defined in Section 97170. 

(b) If a value for a data element, other than data elements specified in 
Subsection (b)(1), is unknown or not applicable, a hospital may submit 
the record without a value for that data element. The Office may require 
a hospital to provide data to replace missing data element values, pur- 
suant to Section 97192. 

(1) A valid value must be submitted for the following data elements: 
Facility Identification Number, Medical Record Number, Responsible 
Surgeon Name, Responsible Surgeon California License Number, Iso- 
lated CABG, Date of Surgery, Date of Discharge, Discharge Status, Gen- 
der, Status of the Procedure, Dialysis, and Prior PCI. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128745, Health and Safety Code. 

History 

1. New section filed 4-29-2003; operative 4-29-2003 pursuant to Government 
Code section 11343.4 (Register 2003, No. 18). 

2. Amendment filed 2-2-2006; operative 3-4-2006 (Register 2006, No. 5). 

§ 97176. Reporting Periods and Due Date. 

(a) During each calendar year there are two reporting periods. The first 
reporting period is January 1 through June 30; the second period is July 
1 through December 3 1 . 

(b) If there has been a change in the licensure of a hospital , the effective 
date of a change in licensee shall constitute the start of the reporting peri- 



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Health Planning and Facility Construction 



§ 97186 



od for the new licensee, and this first reporting period shall end on June 
30 or December 3 1 , whichever occurs first. The final day of the reporting 
period for the previous licensee shall be the last day their licensure was 
effective. 

(c) A hospital shall file a report by the date the report is due. The due 
date is 90 days after the end of a reporting period. 

(d) When a report due date is a Saturday, Sunday, or a state observed 
holiday, a report shall be considered timely if filed on the next business 
day. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference; Sec- 
tion 128745, Health and Safety Code. 

History 

I . New section filed 4-29-2003; operative 4-29-2003 pursuant to Government 
Code section 1 1343.4 (Register 2003, No. 18). 

§ 97178. Extensions to File Report. 

(a) Extensions are available to a hospital that is unable to file a report 
by the due date. The Office shall grant in extensions no more than a cu- 
mulative total of 30 days per report. 

(b) If a hospital files a report before the due date of an extension, the 
days not used will be applied to the number of remaining extension days 
for the report. 

(c) The Office shall grant to a hospital one automatic extension of 10 
days for a report that has not been filed by a due date established pursuant 
to Section 97176 or Subsection (b) of Section 97186, to the extent that 
extension time is available. 

(d) In addition to the automatic extensions provided for in Subsection 
(c), a hospital may request extensions. A request for an extension shall 
be filed on or before the due date of a report and supported by a written 
justification that provides sufficient cause for the approval of the exten- 
sion request. The Office may seek additional information from a request- 
ing hospital. To provide the Office a basis to determine sufficient cause, 
a written justification shall include a factual statement indicating: 

(1) the actions taken by the hospital to produce the report by the due 
date; 

(2) those factors that prevent completion of the report by the due date; 
and 

(3) the actions and the time (days) needed to accommodate those fac- 
tors. 

(e) The Office shall respond in writing by either granting a hospital 
what is determined to be a reasonable extension or disapproving the re- 
quest. If a hospital has been granted an extension, the Office shall notify 
the hospital of the new due date for the report. 

NOTE; Authority cited; Section 128810, Health and Safety Code. Reference; Sec- 
tion 128745, Health and Safety Code. 

History 

1. New section filed 4-29-2003; operative 4-29-2003 pursuant to Government 
Code section 1 1343.4 (Register 2003, No. 18). 

2. Amendment of subsection (a) filed 2-2-2006; operative 3^-2006 (Register 
2006, No. 5). 

§ 971 80. Method of Data Collection. 

(a) A hospital shall use one of the following methods to collect the re- 
quired data elements, as specified in Section 97174, for a report: 

(1) The CCORP data collection tool for the report period, 

(2) A National Society of Thoracic Surgeons (STS) approved software 
vendor tool developed for collection of CCORP data, or 

(3) Another data collection system that generates an electronic report, 
which meets the data requirements in Section 97 1 74 and the format spec- 
ifications in Section 97182. 

(b) A hospital not using the CCORP data collection tool shall submit 
to the Office a test report before it files its first report using an alternate 
system if any of the following conditions are met: 

(1) there is a change in the data requirements in Section 97174 or in 
the format specifications in Section 97182 

(2) the data collection tool used by the hospital has been modified by 
the vendor or is different from the one used in the prior data collection 
period, or 



(3) a hospital using an STS approved software changes to a different 
STS software program. 

(c)The test report should contain at least one record that meets the data 
requirements in Section 97174 and the format specifications in Section 
97182. The hospital should provide the Office the test report 90 days 
prior to the due date for the hospital's next report. The Office will notify 
the hospital whether the submitted test report met the data requirements 
in Section 97174 and the format specificafions in Section 97182. 

(d) The Office shall furnish each hospital, upon request and at no cost, 
a copy of the CCORP data collection tool. 

NOTE: Authority cited; Section 128810, Health and Safety Code. Reference; Sec- 
tion 128745, Health and Safety Code. 

History 

1. New section filed 4-29-2003; operative 4-29-2003 pursuant to Government 
Code section 11343.4 (Register 2003, No. 18). 

2. Amendment of subsections (a)(1) and (b), new subsections (b)(l)-(3), rede- 
signation of portion of former subsecfion (b) as subsection (c), and subsection 
relettering filed 2-2-2006; operative 3-4-2006 (Register 2006, No. 5). 

§97182. Report Format. 

(a) A hospital shall file a report to the Office on one of the following 
media: 

(1) IBM PC-compatible diskette, or 

(2) compact disk (CD). 

(b) A hospital shall file a report in a comma-delimited ASCII file with 
the following format specifications: 

(1) Labels idenfifying each data element on the first data row, and 

(2) Data elements listed in the order set forth in Secfion 97174. 
NOTE: Authority cited; Section 128810, Health and Safety Code. Reference; Sec- 
tion 128745, Health and Safety Code. 

History 
1. New section filed 4-29-2003; operative 4—29-2003 pursuant to Government 
Code section 11343.4 (Register 2003, No. 18). 

§ 971 84. Report Acceptance Criteria. 

The following requirements must be met for the Office to accept a re- 
port: 

(a) The Office is able to read the diskette or compact disk (CD) on 
which the report is submitted. 

(b) The diskette or CD contains data for only one hospital and one re- 
porting period. 

(c) All required completed and signed CCORP Surgeon Certification 
Forms are included with the report, pursuant to Section 97188. 

(d) A completed and signed CCORP Hospital Certification Form is in- 
cluded with the report, pursuant to Secfion 97190. 

(e) The facility identification number on each of the records in the re- 
port is consistent with the facility identification number specified on the 
CCORP Hospital Certification Form. 

(f) The patient discharge date on each of the records in the report is 
consistent with the report period specified on the CCORP Hospital Certi- 
ficadon Form. 

(g) The report contains data for the specified reporting period, and 
contains the number of records stated on the CCORP Hospital Certifica- 
tion Form. 

(h) Each record in the report contains data values for the data elements 
specified in Subsecfion (b)(r) of Section 97174. 

(i) The report complies with the format specificafions set forth in Sec- 
tions 97182. 

NOTE: Authority cited; Section 128810, Health and Safety Code. Reference; Sec- 
tion 128745, Health and Safety Code. 

History 

1. New section filed 4-29-2003; operafive 4-29-2003 pursuant to Government 
Code section 11343.4 (Register 2003, No. 18). 

2. Amendment of subsecuons (c)-(d) filed 2-2-2006; operative 3^-2006 (Regis- 
ter 2006, No. 5). 

§ 97186. Report Acceptance or Rejection. 

(a) The Office shall accept or reject each report within 60 days of re- 
ceipt. A report shall be considered not filed on the date that a hospital re- 
ceives notice from the Office that a report has been rejected. 



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BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



(b) When the Office rejects a report upon initial submission by a hospi- 
tal, the Office shall provide a hospital J days to resubmit the report. The 
Office shall notify a hospital of the new due date for the report. 

(c) When the Office rejects a report a second or subsequent time, the 
Office may provide a hospital 5 days to resubmit the report. The Office 
shall notify a hospital of the new due date for the report. 

(d) For additional time to resubmit a report, a hospital also may request 

extensions, pursuant to Section 97178. 

Note Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128745, Health and Safety Code. 

History 

]. New section filed 4-29-2003; operative 4-29-2003 pursuant to Government 
Code section 11343.4 (Register 2003, No. 18). 



§ 97188. Surgeon Certification of Data. 

(a) Each surgeon identified as a responsible surgeon in a report shall 
attest to the accuracy of the reported data for his or her CABG surgeries 
using the CCORP Surgeon Certification Form (OSH-CCORP 415 (Re- 
vised 05/05)). 

(b) The CCORP Surgeon Certification Form (OSH-CCORP 415 (Re- 
vised 05/05)) shall include the following information: the surgeon's 
name, the surgeon's California physician license number, the hospital 
name, the facility identification number, as defined in Section 97170, the 
reporting period's beginning and ending dates, the number of records in 
the report, and the following Statement of Certification, to be signed by 
the surgeon: 

I, (name of surgeon) , affirm that the cases assigned to me in this 
California CABG Outcomes Reporting Program report are accurate, and 
that I have reviewed these data for accuracy and completeness. I also un- 
derstand that these data, after any corrections or revisions required by the 
Office of Statewide Health Planning and Development, will be used to 
compute my risk-adjusted mortality rate for coronary artery bypass graft 
surgery, and that the Office of Statewide Health Planning and Develop- 
ment will assign data elements with invalid or missing values the lowest 
risk value as observed in the most current risk-adjustment model for pre- 
dicting mortality. 

Name: 

Address: 

Telephone: 

Email: 

Signature: 

Dated: 

(c) The surgeon's name and physician license number specified on the 
CCORP Surgeon Cerfification Form (OSH-CCORP 415 (Revised 
05/05)) shall be consistent with the surgeon's name and physician license 
number as provided in the submitted hospital records, and match the 
California Medical Board licensing information. 

(d) If a responsible surgeon does not complete and sign a CCORP Sur- 
geon Certification Form (OSH-CCORP 4 15 (Revised 05/05)), a hospital 
shall provide the surgeon's name, physician license number, and number 
of cases reported for the surgeon as part of the CCORP Hospital Certifi- 
cadon Form (OSH-CCORP 416 (Revised 05/05)), pursuant to Section 
97190. 

(e) With a report, a hospital shall file with the Office all completed and 
signed CCORP Surgeon Certificafion Forms (OSH-CCORP 415 (Re- 
vised 05/05)). 

(f) A hospital may obtain copies of the CCORP Surgeon Certification 
Form (OSH-CCORP 415 (Revised 05/05)) on the Office's web site or 
by contacting the Office. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128745, Health and Safety Code. 

History 

1. New section filed 4—29-2003; operative 4-29-2003 pursuant to Government 
Code section 11343.4 (Register 2003, No. 18). 

2. Amendment filed 2-2-2006; operative 3^1-2006 (Register 2006, No. 5). 



§ 97190. Hospital Certification of Data. 

(a) With a report, a hospital shall file with the Office a completed 
CCORP Hospital Certification Form (OSH-CCORP 416 (Revised 
05/05)), including the following informafion: the hospital name, the fa- 
cility identification number, as defined in Section 97170, the reporting 
period's beginning and ending dates, the number of records in the report, 
the data collection tool used (CCORP, Society of Thoracic Surgeons (in- 
cluding name of vendor), or other), the number of signed and complete 
CCORP Surgeon Certification Forms (OSH-CCORP 415 (Revised 
05/05)) included with the report, the number of responsi ble surgeons who 
did not sign and complete a CCORP Surgeon Certification Form for the 
report, and the Statement of Certificafion, to be signed by the hospital's 
Chief Executive Officer or designee, as defined in Subsection (e) of Sec- 
tion 97170. 

(b) If a responsible surgeon does not complete and sign a CCORP Sur- 
geon Ceruficafion Form "(OSH-CCORP 415 (Revised 05/05)) pursuant 
to Section 97188, a hospital shall provide the surgeon's name, physician 
license number, and number of cases reported for the surgeon on the 
CCORP Hospital Certification Form (OSH-CCORP 416 (Revised 
05/05)), as part of the Statement of Certificafion. The surgeon's name and 
physician license number provided in the CCORP Hospital Cerfification 
Form (OSH-CCORP 416 (Revised 05/05)) shall be consistent with the 
surgeon's name and physician license number as submitted in the hospi- 
tal report, and match the California Medical Board licensing information. 

(c) If all responsible surgeons complete and sign a CCORP Surgeon 
Ceruficafion Form (OSH-CCORP 415 (Revised 05/05)) pursuant to 
Secfion 971 88, a hospital shall affirm that no surgeons failed to complete 
and sign a CCORP Surgeon Cerfificarion Form by wrifing 'none' on the 
CCORP Hospital Cerfificafion Form (OSH-CCORP 416 (Revised 
05/05)), as part of the Statement of Certification. 

(d) The Statement of Cerfification, to be signed by the hospital's Chief 
Execufive Officer (CEO) or designee shall state: 

I, (name of CEO or designee), certify under penalty of perjury as fol- 
lows: That I am an official of (name of hospital) and am duly authorized 
to submit this California CABG Outcomes Reporfing Program report, 
and that, to the extent of my knowledge and informafion, the accompany- 
ing data are true and correct, and that the definifions of data elements as 
set forth in Section 971 74 of Title 22 of the California Code of Regula- 
tions have been followed by this hospital. 

I cerfify that the following surgeon(s), if any, did not complete a 
CCORP Surgeon Cerfificafion Form and that each was provided the data 
for the cases assigned to him or her in this California CABG Outcomes 
Reporfing Program report and was given an opportunity to review the 
data for accuracy and completeness. 

(Surgeon name) (California physician license number) (Number of 
cases reported) 

I also certify that each surgeon(s) listed above was informed that the 
data for his or her cases, after any correcfions or revisions required by the 
Office of Statewide Health Planning and Development, will be used to 
compute his or her risk-adjusted mortality rate for coronary artery by- 
pass graft surgery, and that the Office of Statewide Health Planning and 
Development will assign data elements with invalid or missing values the 
lowest risk value as observed in the most current risk-adjustment model 
for predicfing mortality. 

Name: 

Tide: 

Address: 

Telephone: 

Email: 

Signature: 

Dated: 

(e) A hospital may obtain copies of the CCORP Hospital Certificafion 
Form (OSH-CCORP 416 (Revised 05/05)) on the Office's web site or 
by contacting the Office. 



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§ 97210 



• 



• 



NOTE: Authority cited: Section 128810. Health and Safety Code. Reference: Sec- 
tion 128745, Health and Safety Code. 

History 

1. New section filed 4-29-2003; operative 4-29-2003 pursuant to Government 
Code section 1 1343.4 (Register 2003, No. 18). 

2. Amendment filed 2-2-2006; operative 3-4-2006 (Register 2006, No. 5). 

§ 97192. Correction of Data. 

(a) After a report has been accepted pursuant to Section 97 1 86, a hos- 
pital may be required to provide the Office with data to replace invalid 
or missing data element values. 

(b) The Office shall notify each hospital of its final opportunity to 
make corrections and revisions to submitted data at least 60 days before 
the Office conducts analyses to identify hospitals and surgeons for pos- 
sible audit. From the date of notification, a hospital shall have 30 days to 
submit all corrections and revisions to the Office. The Office may require 
documentation to support data changes requested by a hospital. 

(c) If a hospital fails to provide a valid value, as set forth in Section 
97174, or provides no value for a data element in a record, by the end of 
the 30-day period, the Office shall assign the data element in the record 
the lowest risk value as observed in the most current risk adjustment 
model. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128745 and 128748, Health and Safety Code. 

History 

1. New section filed 4-29-2003; operative 4-29-2003 pursuant to Government 
Code section 1 1343.4 (Register 2003, No. 18). 

§97194. Audit Procedure. 

(a) The Office may conduct periodic audits of a hospital ' s patient med- 
ical records for its CABG surgery patients. Audits may, at the Office's 
discretion, be performed at the hospital location. 

(b) The Office shall notify a hospital a minimum of 2 weeks before the 
date of an audit. Upon notification that an audit is planned, a hospital shall 
designate a person to serve as the audit contact person. A hospital shall 
provide to the Office the contact person's name, title, telephone number, 
and electronic mail address. 

(c) A hospital shall retrieve and make available the requested patient 
medical records for an audit, and if requested by the Office, provide a rea- 
sonable space in which the Office may conduct an audit. 

(d) Data abstracted during an audit may, at the Office's discretion, re- 
place data for a given record submitted in a report filed by a hospital. Re- 
placement data shall be used in calculating risk-adjusted mortality rates 
for hospitals and physicians. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128745 and 128748, Health and Safety Code. 

History 

1. New section filed 4-29-2003; operative 4-29-2003 pursuant to Government 
Code section 11 343.4 (Register 2003, No. 18). 

§ 97196. Hospital Data Contact Person. 

(a) Each hospital at which CABG surgeries are performed shall desig- 
nate a CCORP data contact person. A hospital shall notify CCORP in 
writing (hardcopy or electronic mail) within 30 days of the effective date 
of this regulation or within 30 days of beginning or resuming operation. 
A notification shall include the designated person's name, title, tele- 
phone number(s), mailing address, and electronic mail address. 

(b) A hospital shall notify CCORP in writing (hardcopy or electronic 
mail) within 30 days after any change in the person designated as the 
CCORP data contact person, or in the title, telephone number(s), mailing 
address, or electronic mail address, of the individual. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128745, Health and Safety Code. 

History 
1. New section filed 4-29-2003; operative 4-29-2003 pursuant to Government 
Code section 1 1343.4 (Register 2003, No. 18). 

§ 97198. Failure to Fife a CABG Report. 

(a) A civil penalty of one hundred dollars ($100) per day shall be as- 
sessed to a hospital that does not file a report as required by this Article 



by the date it is due. No penalty shall be imposed during an extension pe- 
riod as provided in Section 97178 or a resubmission period as provided 
in Section 97186. 

(b) Within 15 days after the date a report is due, unless an extension 
has been granted as specified in Section 97178, the Office shall notify a 
hospital that has not filed its report of the penalties. 

(c) Assessed penalties may be appealed pursuant to Section 97052 of 
Title 22 of the California Code of Regulations. 

NOTE: Authority cited: Section 1 2881 0, Health and Safety Code. Reference: Sec- 
tion 128745, Health and Safety Code. 

History 

1. New section filed 4-29-2003; operative 4-29-2003 pursuant to Government 
Code section 11343.4 (Register 2003, No. 18). 

2. Amendment of subsection (b) filed 2-2-2006; operative 3-4-2006 (Register 
2006. No. 5). 



Article 8. Patient Data Reporting 
Requirements 

§ 97210. Contact Person, User Account Administrator, 
Designated Agent, and Facility Identification 
Number. 

(a) Each reporting facility shall designate a primary contact person and 
shall notify the Office's Patient Data Program in writing, by electronic 
mail or through the Medical Information Reporting for California (MIR- 
Cal) system of the designated person's name, title, telephone number(s), 
mailing address, and electronic mail address. The designated person will 
be sent time-sensitive electronic mail regarding the facility's data sub- 
mission, including reminder notices, acceptance and rejection notifica- 
tions, and extension information. 

(b) Each reporting facility shall notify the Office's Patient Data Pro- 
gram in writing, by electronic mail, or through the MIRCal system within 
15 days after any change in the person designated as the primary contact 
person, or in the designated primary person' s name, title, telephone num- 
ber(s), mailing address or electronic mail address. 

(c) Each reporting facility beginning or resuming operations, whether 
in a newly constructed facility or in an existing facility, shall notify the 
Office's Patient Data Program in writing, by electronic mail or through 
the MIRCal system within 30 days after its first day of operation of the 
designated primary contact person and the facility administrator. 

(d) Each reporting facihty shall designate up to three User Account 
Administrators pursuant to Subsection (f) of Section 97246. Each report- 
ing facility shall notify the Office's Patient Data Program in writing, by 
electronic mail or through the MIRCal system within 15 days after any 
change in a designated user account administrator's name, title, tele- 
phone number(s), mailing address, or electronic mail address. 

(e) Each reporting facility may submit its own data report to the Of- 
fice' s Pafient Data Program, or it may designate an agent for this purpose. 
The reporting facility shall be responsible for ensuring compliance with 
regulations and reporting requirements when an agent is designated pur- 
suant to Subsection (b) of Section 97246. 

(f) Each reporting facility shall be provided a facility identification 
number that shall be used to submit data to the Office. 

NoTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128700, 128733, 128736 and 128737, Health and Safety Code. 

History 

1. Renumbering and amendment of former title 4, chapter 10 (sections 
72 1 0-72 1 6) to title 22, division 7 (sections 972 1 0-972 16) filed 1 1 -5-85; desig- 
nated effective 1 - 1 -86 (Register 85, No. 45). For prior history, see Register 85, 
No. 19. 

2. Amendment of subsection (a) filed 7-30-86; effective thirtieth day thereafter 
(Register86, No. 31). 

3. Amendment of section heading and text filed 10-14-93; operafive 11-15-93 
(Register 93, No. 42). 

4. Amendment of subsections (b) and (c) and Note filed 7-23-97 pursuant to sec- 
tion 100, title 1, California Code of Regulations (Register 97, No. 30). 

5. Amendment of subsections (b) and (c) filed 9-21-98; operative 10-21-98 
(Register 98, No. 39). 



Page 1238.7 



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§ 97211 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



6. Amendment of section heading and section filed 9-23-2003; operative 
9-23-2003 pursuant to Government Code section 1 1 343.4 (Resister 2003. No. 
39). 

7. Amendment of article heading, section and Note filed 5-5-2005; operative 
5-5-2005 pursuant to Government Code section 1 1 343.4 (Register 2005, No. 
18). 

8. Amendment of subsection (a) filed 11-21-2006; operative 11-21-2006 pur- 
suant to Govemment Code section 1 1343.4 (Register 2006. No. 47). 

§ 9721 1 . Reporting Periods and Due Dates. 

(a) The prescribed reporting periods are: 

(1) Calendar semiannual for Hospital Discharge Abstract Data re- 
ports, which means that there are two reporting periods each year, con- 
sisting of discharges occurring January 1 through June 30 and discharges 
occurring July 1 through December 31. 

(2) Calendar quarterly for Emergency Care Data reports, which means 
there are four reporting periods each year, consisting of encounters oc- 
curring January 1 through March 31, encounters occurring April 1 
through June 30, encounters occurring July 1 through September 30, and 
encounters occurring October 1 through December 31. 

(3) Calendar quarteriy for Ambulatory Surgery Data reports, from a 
hospital or from a freestanding ambulatory surgery clinic, which means 
there are four reporting periods each year, consisting of encounters oc- 
curring January 1 through March 31, encounters occurring April 1 
through June 30, encounters occurring July 1 through September 30, and 
encounters occurring October 1 through December 3 1 . 

(b) Where there has been a change in the licensee, the effective date 
of the change shall constitute the start of the reporting period for the new 
licensee. The end of the first reporting period for the new licensee shall 
be the end of the prescribed reporting period. The fmal day of the report- 
ing period for the previous licensee shall be the last day their licensure 
was effective. 

(c) Report due dates: 

(1) For Hospital Discharge Abstract Data reports, for discharges oc- 
curring on or after January 1, 2003, and all subsequent report periods, the 
report due date shall be three months after the end of each reporting peri- 
od; thus the due date for the January 1 through June 30 reports is Septem- 
ber 30 of the same year and the due date for the July 1 through December 
31 reports is March 31 of the following year. 

(2) For Emergency Care Data reports, for encounters occurring on or 
after October 1, 2004, and all subsequent report periods, the report due 
date shall be 45 days after the end of each reporting period; thus the due 
date for the January 1 through March 31 reports is May 15 of the same 
year, the due date for the April 1 through June 30 reports is August 14 of 
the same year, the due date for the July 1 through September 30 reports 
is November 14 of the same year, and the due date for the October 1 
through December 31 reports is February 14 of the following year. 

(3) For Ambulatory Surgery Data reports, for encounters occurring on 
or after October 1 , 2004, and all subsequent report periods, the report due 
date shall be 45 days after the end of each reporting period; thus the due 
date for the January 1 through March 31 reports is May 15 of the same 
year, the due date for the April 1 through June 30 reports is August 14 of 
the same year, the due date for the July 1 through September 30 reports 
is November 14 of the same year, and the due date for October 1 through 
December 31 reports is February 14 of the following year. 

(d) Data reports shall be filed, as defined by Subsection (j) of Section 
97005, by the date the data report is due. Where a reporting facility has 
been granted an extension, pursuant to Section 97241, the ending date of 
the extension shall constitute the new due date for that data report. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128735, 128736 and 128737, Health and Safety Code. 

History 

1. Repealer and new section filed 10-14-93; operative 11-15-93 (Register 93, 
No. 42). For prior history, see Register 86, No. 31. 

2. Amendment of section and Note filed 7-23-97 pursuant to section 100, title 1, 
California Code of Regulations (Register 97, No. 30). 



3. Amendment filed 9-23-2003; operative 9-23-2003 pursuant to Govemment 
Code section ] 1343.4 (Register 2003, No. 39). 

4. Amendment of section and Note filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 11343.4 (Register 2005, No. 18). 



§ 97212. Definitions, as Used in Tliis Article. 

(a) Ambulatory Surgery (AS) Data Record. The Ambulatory Surgery 
Data Record consists of the set of data elements related to an encounter, 
as specified in Subsection (a) of Section 128737 of the Health and Safety 
Code and as defined in Sections 97251-97265. 

(b) CPT-4. The Current Procedural Terminology, 4th Edition, is pub- 
hshed and maintained by the American Medical Association. It is a stan- 
dard medical code set for healthcare services or procedures in non-inpa- 
tient settings. 

(c) Days. Days, as used in this article, are defined as calendar days un- 
less otherwise specified. 

(d) Designated Agent. An entity designated by a reporting facility to 
submit that reporting facility's data records to the Office's Patient Data 
Program. 

(e) Discharge. A discharge is defined as an inpatient who: 

(1 ) is formally released from the care of the hospital and leaves the hos- 
pital, or 

(2) is transferred within the hospital from one type of care to another 
type of care, as defined by Subsection (x) of Section 97212, or 

(3) leaves the hospital against medical advice, without a physician's 
order or is a psychiatric patient who is discharged as away without leave 
(AWOL), or 

(4) has died. 

(f) DRG. Diagnosis Related Groups is a classification scheme with 
which to categorize inpafients according to clinical coherence and ex- 
pected resource intensity, as indicated by their diagnoses, procedures, 
age, sex, and disposifion, and was established and is revised annually by 
the U.S. Department of Health and Human Services (DHHS) Centers for 
Medicare and Medicaid Services (CMS), formerly known as the U.S. 
Health Care Financing Administration. 

(g) Do .Not Resuscitate (DNR) Order. A DNR order is a directive from 
a physician in a patient's current inpatient medical record instructing that 
the patient is not to be resuscitated in the event of a cardiac or pulmonary 
arrest. In the event of a cardiac or pulmonary arrest, resuscitative mea- 
sures include, but are not limited to, the following: cardiopulmonary re- 
suscitation (CPR), intubation, defibrillation, cardioactive drugs, or as- 
sisted ventilation. 

(h) Emergency Care Data Record. The Emergency Care Data Record 
consists of the set of data elements related to an encounter, as specified 
in Subsection (a) of Section 128736 of the Health and Safety Code and 
as defined in Sections 97251-97265. 

(i) Emergency Department (ED). Emergency Department means, in a 
hospital licensed to provide emergency medical services, the location in 
which those services are provided, as specified in Subsection (c) of Sec- 
tion 128700 of the Health and Safety Code. For the purposes of this chap- 
ter, this includes emergency departments providing standby, basic, or 
comprehensive services. 

(j) Encounter. An encounter is a face-to-face contact between an out- 
patient and a provider. 

(k) Error. Error means any record found to have an invahd entry or to 
contain incomplete data or to contain illogical data. 

(/) Facility Identification Number. A unique six-digit number that is 
assigned to each facility and shall be used to identify the facihty. 

(m) Freestanding Ambulatory Surgery Clinic. Freestanding ambulato- 
ry surgery clinic means a surgical clinic that is licensed by the state under 
paragraph (1) of subdivision (b) of Section 1204 of the Health and Safety 
Code. This type of facility is commonly known as a freestanding ambula- 
tory surgery center. 



• 



[The next page is 1239.] 

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Title 22 



Health Planning and Facility Construction 



§ 97213 



(n) Hospital Discharge Abstract Data Record: The Hospital Discharge 
Abstract Data Record consists of the set of data elements related to a dis- 
charge, as specified in Subsection (g) of Section 128735 of the Health and 
Safety Code and as defined by Sections 97216-97233 for Inpatients. 

(0) ICD-9-CM. The International Classification of Diseases, 9th Re- 
vision, Clinical Modification, published by the U.S. Department of 
Health and Human Services. Coding guidelines and annual revisions to 
1CD-9-CM are made nationally by the "cooperating parties" (the Ameri- 
can Hospital Association, the Centers for Medicare and Medicaid Ser- 
vices, the National Center for Health Statistics, and the American Health 
Information Management Association). 

(p) Inpatient. An inpatient is defined as a baby born alive in this hospi- 
tal or a person who was formally admitted to the hospital for observation, 
diagnosis, or treatment, with the expectation of remaining overnight or 
longer. 

(q) Licensee. Licensee means an entity that has been issued a license 
to operate a facility as defined by Subsection (e) or (g) of Section 1 28700 
of the Health and Safety Code. 

(r) MIRCal. MIRCal means the OSHPD Medical Information Report- 
ing for California system that is the online transmission system through 
which reports are submitted using an Internet web browser either by file 
transfer or data entry. It is a secure means of electronic transmission of 
data in an automated environment and allows facilities to edit and correct 
data held in a storage database until reports meet or exceed the Approval 
Criteria specified in Section 97247. 

(s) Outpatient. An outpatient means: 

(1) a person who has been registered or accepted for care but not for- 
mally admitted as an inpatient and who does not remain over 24 hours, 
as specified in Subsection (a)(2) of Section 70053 of Title 22 of the 
California Code of Regulations, or 

(2) a patient at a freestanding ambulatory surgery clinic who has been 
registered and accepted for care. 

(t) Provider. A provider is the person who has primary responsibility 
for assessing and treating the condition of the patient at a given contact 
and exercises independent judgment in the care of the patient. This would 
include a practitioner licensed as a Medical Doctor (M.D.), a Doctor of 
Osteopathy, (D.O.), a Doctor of Dental Surgery (D.D.S.), or a Doctor of 
Podiatric Medicine (D.P.M.). 

(u) Record. A record is defined as the set of data elements specified in 
Subsection (g) of Section 128735, Subsection (a) of Section 128736, or 
Subsection (a) of Section 128737 of the Health and Safety Code, for one 
discharge or for one encounter. 

(v) Report. A report is defined as the collection of all Hospital Dis- 
charge Abstract Data Records, or all Emergency Care Data Records, or 
all Ambulatory Surgery Data Records required to be submitted by a re- 
porting facility for one reporting period. A report contains only one type 
of record. 

(w) Reporting Facility. Reporting facility means a hospital or a free- 
standing ambulatory surgery clinic required to submit data records, as 
specified in Subsection (g) of Section 128735, or Subsection (a) of Sec- 
tion 128736, or Subsection (a) of Section 128737 oftheHealth and Safety 
Code. 

(x) Type of Care. Type of care in hospitals is defined as one of the fol- 
lowing: 

(1) Skilled nursing/intermediate care. Skilled nursing/intermediate 
care means inpatient care that is provided to inpatients occupying beds 
appearing on a hospital's license in the classifications of skilled nursing 
or intermediate care, as defined by paragraphs (2), (3), or (4) of Subdivi- 
sion (a) of Section 1250.1 of the Health and Safety Code. Skilled nursing/ 
intermediate care also means inpatient care that is provided to inpatients 
occupying general acute care beds that are being used to provide skilled 
nursing/intermediate care to those inpatients in an approved swing bed 
program. 

(2) Physical rehabilitation care. Physical rehabilitation care means in- 
patient care that is provided to inpatients occupying beds included on a 
hospital's license within the general acute care classification, as defined 



by paragraph (1) of Subdivision (a) of Section 1250.1 of the Health and 
Safety Code, and designated as rehabilitation center beds, as defined by 
Subsection (a) of Section 70034 and by Section 70595 of Title 22 of the 
California Code of Regulations. 

(3) Psychiatric care. Psychiatric care means inpatient care that is pro- 
vided to inpatients occupying beds appearing on a hospital's license in 
the classification of acute psychiatric beds, as defined by paragraph (5) 
of Subdivision (a) Section 1250.1 of the Health and Safety Code, and 
psychiatric health facility, as defined by Subdivision (a) of Section 

1250.2 of the Health and Safety Code. 

(4) Chemical dependency recovery care. Chemical dependency re- 
covery care means inpatient care that is provided to inpatients occupying 
beds appearing on a hospital's license as chemical dependency recovery 
beds, as defined by paragraph (7) of Subdivision (a) of Section 1250.1 
of the Health and Safety Code and Subdivisions (a), (c), or (d) of Section 

1250.3 of the Health and Safety Code. 

(5) Acute care. Acute care, as defined by paragraph (1 ) of Subdivision 
(a) of Section 1 250. 1 of the Health and Safety Code, means all other types 
of inpatient care provided to inpatients occupying all other types of li- 
censed beds in a hospital, other than those defined by paragraphs (1), (2), 
(3) and (4) of Subsection (x) of this section. 

(y) User Account Administrator. A healthcare facility representative 
responsible for maintaining the facility's MIRCal user accounts and user 
account contact information. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 1250, 1250.1, 128700, 128735, 128736 and 128737, Health and Safety Code. 

History 

1. New section applicable to all discharges after December 31, 1996 filed 
7-13-96; operative 8-14-96 (Register 96, No. 29). 

2. Editorial correction of subsections (c)(2) and (g)(2) (Register 97, No. 19). 

3. Amendment of section and Note filed 7-23-97 pursuant to section 100, title 1, 
California Code of Regulations (Register 97, No. 30). 

4. Repealer of version of section 97212 applicable through 12-31-96 and amend- 
ment of version of section applicable beginning 1-1-97 filed 9-21-98; opera- 
tive 10-21-98 (Register 98, No. 39). For prior history see Register 97, No. 30. 

5. Amendment filed 9-23-2003; operative 9-23-2003 pursuant to Government 
Code section II 343 .4 (Register 2003, No. 39). 

6. Repealer and new section and amendment of Note filed 5-5-2005; operative 
5-5-2005 pursuant to Government Code section 1 1343.4 (Register 2005, No. 
18). 

7. Change without regulatory effect amending subsection (p) filed 8-1 1 -2005 pur- 
suant to section 100, title I, California Code of Regulations (Register 2005, No. 
32). 

§97213. Required Reporting. 

(a) (1) Hospital Discharge Abstract Data: Each hospital shall submit 
a hospital discharge abstract data record, as specified in Subdivision (g) 
of Section 1 28735 of the Health and Safety Code, for each inpatient dis- 
charged during the semiannu^il reporting period, according to the format 
specified in Subsection (a) of Section 97215 and by the dates specified 
in Subsection (c)(1) of Section 97211. 

(2) Emergency Care Data: Each hospital shall submit an emergency 
care data record, as specified in Subsection (a) of Section 128736 of the 
Health and Safety Code, for each encounter during the quarterly report- 
ing period, according to the format specified in Subsection (b) of Section 
97215 and by the dates specified in Subsection (c)(2) of Section 97211. 
A hospital shall not report an Emergency Care Data Record if the encoun- 
ter resulted in a same-hospital admission. 

(3) Ambulatory Surgery Data: Each hospital and freestanding ambula- 
tory surgery clinic shall submit an ambulatory surgery data record, as 
specified in Subsection (a) of Section 128737 of the Health and Safety 
Code, for each encounter during which at least one ambulatory surgery 
procedure is performed, during the quarterly reporting period, according 
to the format specified in Subsection (c) of Section 97215 and by the 
dates specified in Subsection (c)(3) of Section 97211. An ambulatory 
surgery procedure is defined by Subsection (a) of Section 128700 of the 
Health and Safety Code as those procedures performed on an outpatient 
basis in the general operating rooms, ambulatory surgery rooms, endos- 
copy units, or cardiac catheterization laboratories of a hospital or a free- 
standing ambulatory surgery clinic. A hospital shall not report an Ambu- 



Page 1239 



Register 2006, No. 47; 11-24-2006 



§ 97214 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



latory Surgery Data Record if the encounter resulted in a same-hospital 
admission. 

(b) A hospital shall separately identify records of inpatients being dis- 
charged from the acute care type of care, as defined by paragraph (5) of 
Subsection (x) of Section 97212. The hospital shall identify these records 
by recording a "1 " on each of these records as specified in the Format and 
Specifications for Online Transmission in Section 97215. 

(c) A hospital shall separately identify records of inpatients being dis- 
charged from the skilled nursing/intermediate care type of care, as de- 
fined by paragraph (J ) of Subsection (x) of Section 9721 2. The hospital 
shall identify these records by recording a "3" on each of these records 
as specified in the Format and Specifications for Online Transmission in 
Section 97215. 

(d) A hospital shall separately identify records of inpatients being dis- 
charged from the psychiatric care type of care, as defined by paragraph 
(3) of Subsection (x) of Section 97212. The hospital shall identify these 
records by recording a "4" on each of these records as specified in the 
Format and Specifications for Online Transmission in Section 97215. 

(e) A hospital shall separately identify records of inpatients being dis- 
charged from the chemical dependency recovery care type of care, as de- 
fined by paragraph (4) of Subsection (x) of Section 9721 2. The hospital 
shall identify these records by recording a "5" on each of these records 
as specified in the Format and Specifications for Online Transmissions 
in Section 97215. 

(f) A hospital shall separately identify records of inpatients being dis- 
charged from the physical rehabilitafion care type of care, as defined by 
paragraph (2) of Subsecuon (x) of Secfion 97212. The hospital shall iden- 
tify these records by recording a "6" on each of these records as specified 
in the Format and Specifications for Online Transmissions in Secfion 
97215. 

(g) Licensees operafing and maintaining more than one physical plant 
on separate premises under a single consolidated license who choose to 
file separate data reports for each location must request, in wrifing, a 
modification to file separate data reports for each locafion. A licensee 
granted a modificafion under this paragraph shall be responsible for all 
regulatory requirements for each separate report. Separate extension re- 
quests, filed under the provisions of Secfion 97241 , shall be required for 
each report, and penalties, assessed pursuant to Secfion 97250, shall be 
assessed on each delinquent report. 

NOTE: Authority cited: Section 128810 Health and Safety Code. Reference: Sec- 
tions 128735, 128736 and 128737, Health and Safety Code. 

History 

1. New section applicable to all discharges after December 31, 1996 filed 
7-15-96; operative 8-14-96 (Register 96, No. 29). 

2. Editorial correcfion of subsection (d) (Register 97, No. 19). 

3. Editorial coirection of subsection (d) (Register 97, No. 30). 

4. Amendment of section and Note filed 7-23-97 pursuant to section 100, title 1 , 
California Code of Regulafions (Register 97, No. 30). 

5. Repealer of version of section 97213 applicable through 12-31-96 and amend- 
ment of version of section 97213 applicable beginning 1-1-97 filed 9-21-98; 
operative 10-21-98 (Register 98, No. 39). For prior history see Register 97, No. 
30. 

6. Amendment filed 9-23-2003; operative 9-23-2003 pursuant to Government 
Code section 1 1343.4 (Register 2003, No. 39). 

7. Amendment of section and Note filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code secfion 1 1343.4 (Register 2005, No. 18). 

§97214. Form of Authentication. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
fion 128735, Health and Safety Code. 

History 

1. New section appficable to all discharges after December 31, 1996 filed 
7-15-96; operafive 8-14-96 (Register 96, No. 29). 

2. Amendment filed 7-23-97 pursuant to secfion 100, fitle 1, Cahfomia Code of 
Regulafions (Register 97, No. 30). 

3. Repealer of version of secfion 97214 applicable through 12-31-96 and amend- 
ment of version of section 97214 applicable beginning 1-1-97 filed 9-21-98; 
operafive 10-21-98 (Register 98, No. 39). For prior history see Register 97, No. 
30. 

4. Repealer filed 9-23-2003; operative 9-23-2003 pursuant to Government Code 
section 1 1343.4 (Register 2003, No. 39). 



§97215. Format. 

(a) Hospital Discharge Abstract Data reports for discharges occurring 
on or after January 1, 2005, shafi comply with the Office's Format and 
File Specifications for MIRCal Online Transmission Patient Discharge 
Data, dated April 2004, and hereby incorporated by reference. 

(b) Emergency Care Data reports for encounters occurring on or after 
January 1, 2005, shall comply with the Office's Format and File Specifi- 
cations for MIRCal Online Transmission Emergency Care and Ambula- 
tory Surgery Data, dated April 2004, and hereby incorporated by refer- 
ence. 

(c) Ambulatory Surgery Data reports for encounters occurring on or 
after January 1, 2005, shall comply with the Office's Format and File 
Specificafions for MIRCal Online Transmission Emergency Care and 
Ambulatory Surgery Data, dated April 2004. 

(d) The Office's Format and File Specifications for MIRCal Online 
Transmission as named in (a), (b), and (c) are available for download 
from the MIRCal website. The Office will make a hardcopy of either set 
of Format and File Specificafions for MIRCal Online Transmission 
available to a reporting facility or designated agent upon request. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128735, 128736 and 128737, Health and Safety Code. 

History 

1 . Amendment of subsecfions (c) and (d) filed 2-22-90; operative 3-24-90 (Reg- 
ister 90, No. 9). 

2. Renumbering of former section 97215 to new secfion 97242 and new secfion 

97215 filed 10-14-93; operafive 11-15-93 (Register 93, No. 42). 

3. Editorial correction of printing errors (Register 94, No. 17). 

4. Amendment of first and second paragraphs filed 11-27-95; operative 1-1-96 
(Register 95, No. 48). 

5. Amendment of first three paragraphs and Note filed 7-15-96; operative 
8-14-96 (Register 96, No. 29). 

6. Amendment filed 7-23-97 pursuant to secfion 100, title 1, California Code of 
Regulations (Register 97, No. 30). 

7. Amendment filed 9-21-98; operative 10-21-98 (Register 98, No. 39). 

8. Repealer and new secfion filed 9-23-2003; operafive 9-23-2003 pursuant to 
Government Code secfion 1 1343.4 (Register 2003, No. 39). 

9. Amendment of section and Note filed 5-5-2005; operafive 5-5-2005 pursuant 
to Government Code secfion 11343.4 (Register 2005, No. 18). 

§ 97216. Definition of Data Element for Inpatients— Date of 
Birth. 

The patient's birth date shall be reported in numeric form as follows: 
the 2-<ligit month, the 2-digit day, and the 4-digit year of birth. The nu- 
meric form for days and months from 1 to 9 must have a zero as the first 
digit. When the complete date of birth is unknown, as much of the date 
as is known shall be reported. At a minimum, an appropriate year of birth 
shall be reported. If only the age is known, the esfimated year of birth 
shafi be reported. If the month and year of birth are known, and the exact 
day is not, the year, the month, and zeros for the day shall be reported. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
fion 128735, Health and Safety Code. 

History 

1. Renumbering of former section 97216 to new section 97243 and new section 

97216 filed 10-14-93; operative 1 1-15-93 (Register 93, No. 42). 

2. Amendment of Note filed 7-23-97 pursuant to section 100, title 1, California 
Code of Regulafions (Register 97, No. 30). 

3. Amendment filed 9-21-98; operative 10-21-98 (Register 98, No. 39). 

4. Amendment of secfion heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 11343.4 (Register 2005, No. 18). 

§ 97217. Definition of Data Element for Inpatients— Sex. 

The pafient's gender shaU be reported as male, female, other or un- 
known. "Other" includes sex changes, undetermined sex and live births 
with congenital abnormalities that obscure sex idenfificafion. "Un- 
known" indicates that the pafient's sex was not available from the medi- 
cal record. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
fion 128735, Health and Safety Code. 

History 

1. New secfion filed 10-14-93; operafive 1 1-15-93 (Register 93, No. 42). 

2. Amendment of secfion and Note filed 7-23-97 pursuant to secfion 100, title 1, 
California Code of Regulations (Register 97, No. 30). 



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§ 97222 



3. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 1 8). 

§ 97218. Definition of Data Element for Inpatients — Race. 

Effective with discharges on January 1 , 1995, the patient's ethnic and 
racial background shall be reported as one choice from the following list 
of alternatives under ethnicity and one choice from the following list of 
alternatives under race: 

(a) Ethnicity: 

(1) Hispanic. A person who identifies with oris of Mexican, Puerto Ri- 
can. Cuban, Central or South American, or other Spanish culture or ori- 
gin. 

(2) Non-Hispanic 

(3) Unknown 

(b) Race: 

(1) White. A person having origins in or who identifies with any of the 
original Caucasian peoples of Europe, Nonh Africa, or the Middle East. 

(2) Black. A person having origins in or who identifies with any of the 
black racial groups of Africa. 

(3) Native American/Eskimo/Aleut. A person having origins in or who 
identifies with any of the original peoples of North America, and who 
maintains cultural identification through tribal affiliation or community 
recognition. 

(4) Asian/Pacific Islander. A person having origins in or who identifies 
with any of the original oriental peoples of the Far East, Southeast Asia, 
the Indian subcontinent, or the Pacific Islands. Includes Hawaii, Laos, 
Vietnam, Cambodia, Hong Kong, Taiwan, China, India, Japan, Korea, 
the Philippine Islands, and Samoa. 

(5) Other. Any possible options not covered in the above categories. 

(6) Unknown. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 10-14-93; operative 1 1-15-93 (Register 93, No. 42). 

2. Amendment of section and Note filed 7-23-97 pursuant to section 100, title 1, 
California Code of Regulations (Register 97, No. 30). 

3. Amendment of subsection (b)(4) filed 9-21-98; operative 10-21-98 (Register 
98, No. 39). 

4. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 18). 

§ 97219. Definition of Data Element for Inpatients— ZIP 
Code. 

The "ZIP Code," a unique code assigned to a specific geographic area 
by the U.S. Postal Service, for the patient's usual residence shall be re- 
ported for each patient discharge. Foreign residents shall be reported as 
"YYYYY" and unknown ZIP Codes shall be reported as "XXXXX." If 
the city of residence is known, but not the street address, report the first 
three digits of the ZIP Code, and the last two digits as zeros. Hospitals 
shall distinguish the "homeless" (patients who lack a residence) from 
other patients lacking a numeric ZIP Code of residence by reporting the 
ZIP Code of homeless patients as "ZZZZZ." If the patient has a 9-digit 
ZIP Code, only the first five digits shall be reported. 
Note- Authority cited: Section 12881 0, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 10-14-93; operative 11-15-93 (Register 93, No. 42). 

2. Amendment of section and Note filed 7-23-97 pursuant to section 1 00, title 1 , 
California Code of Regulafions (Register 97, No. 30). 

3. Amendment filed 9-21-98; operative 10-21-98 (Register 98, No. 39). 

4. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 18). 

§ 97220. Definition of Data Element for Inpatients — Patient 
Social Security Number. 

The patient's social security number is to be reported as a 9-digitnum- 
ber. If the patient's social security number is not recorded in the patient's 
medical record, the social security number shall be reported as "not in 
medical record," by reporting the social security number as 
"000000001 ." The number to be reported is to be the patient's social se- 



curity number, not the social security number of some other person, such 

as the mother of a newborn or the insurance beneficiary under whose ac- 

couiit the hospital's bill is to be submitted. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 10-14-93; operafive 11-15-93 (Register 93, No. 42). 

2. Amendment of secfion and Note filed 7-23-97 pursuant to section 100, title 1, 
California Code of Regulations (Register 97, No. 30). 

3. Amendment filed 9-21-98; operative 10-21-98 (Register 98, No. 39). 

4. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code secfion 11 343.4 (Register 2005, No. 18). 

§ 97221 . Definition of Data Element for 
Inpatients — Admission Date. 

The patient's date of admission shall be reported in numeric form as 
follows: the 2-digit month, the 2-digit day and the 4-digit year. The nu- 
meric form for days and months from 1 to 9 must have a zero as the first 
digit. For discharges represenfing a transfer of a patient from one level 
of care within the hospital to another level of care within the hospital, as 
defined by Subsection (x) of Section 97212 and reported pursuant to Sec- 
tion 97212, the admission date reported shall be the date the patient was 
transferred to the level of care being reported on this record. 
NOTE: Authority cited: Secfion 128810, Health and Safety Code. Reference: Sec- 
fion 128735, Health and Safety Code. 

History 

1. New secfion applicable to all discharges after December 31, 1996 filed 
7-15-96; operafive 8-14-96 (Register 96, No. 29). 

2. Amendment filed 7-23-97 pursuant to secfion 100, fitle 1, California Code of 
Regulations (Register 97, No. 30). 

3. Repealer of version of secfion 97221 applicable through 12-3 1-96 and amend- 
ment of version of section 97221 applicable beginning 1-1-97 filed 9-21-98; 
operafive 10-21-98 (Register 98, No. 39). For prior history see Register 97, No. 
30. 

4. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code secfion 1 1343.4 (Register 2005, No. 18). 

§ 97222. Definition of Data Element for Inpatients — Source 
of Admission. 

Effective with discharges on or after January 1, 1997, in order to de- 
scribe the patient's source of admission, it is necessary to address three 
aspects of the source: first, the site from which the patient originated; sec- 
ond, the licensure of the site from which the pafient originated; and, third, 
the route by which the padent was admitted. One alternative shall be se- 
lected from the list following each of three aspects: 

(a) The site from which the pafient was admitted. 

(1) Home. A pafient admitted from the pafient' s home, the home of a 
relative or friend, or a vacation site, whether or not the patient was seen 
at an outpafient clinic or physician's office, or had been receiving home 
health services or hospice care at home. 

(2) Residential Care Facility. A pafient admitted from a facility in that 
the pafient resides and that provides special assistance to its residents in 
acfivities of daily living, but that provides no organized health care. 

(3) Ambulatory Surgery. A pafient admitted after treatment or exami- 
nafion in an ambulatory surgery facility, whether hospital-based or a 
freestanding licensed ambulatory surgery clinic or certified ambulatory 
surgery center. Excludes outpatient clinics and physicians' offices not li- 
censed and/or certified as an ambulatory surgery facility. 

(4) Skilled Nursing/Intermediate Care. A patient admitted from skilled 
nursing care or intermediate care, whether freestanding or hospital- 
based, or from a Congregate Living Health Facility as defined by Subdi- 
vision (i) of Secfion 1250 of the Health and Safety Code. 

(5) Acute Hospital Care. A pafient who was an inpatient at a hospital, 
and who was receiving inpatient hospital care of a medical/surgical na- 
ture, such as a perinatal, pediatric, intensive care, coronary care, respira- 
tory care, newborn intensive care, or bum unit of a hospital. 

(6) Other Hospital Care. A pafient who was an inpafient at a hospital, 
and who was receiving inpatient hospital care not of a medical/surgical 
nature, such as in a psychiatric, physical medicine rehabilitation, or 
chemical dependency recovery treatment unit. 

(7) Newborn. A baby bom alive in this hospital. 



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(8) Prison/Jail. A patient admitted from a correctional institution. 

(9) Other. A patient admitted from a source other than mentioned 
above. Includes patients admitted from a freestanding, not hospital- 
based, inpatient hospice facility. 

(b) Licensure of the site. 

(1) This Hospital. The Ambulatory Surgery, Skilled Nursing/Interme- 
diate Care, Acute Hospital Care, or Other Hospital Care from which the 
patient was admitted was operated as part of the license of this hospital. 
Includes all newborns. 

(2) Another Hospital. The Ambulatory Surgery, Skilled Nursing/In- 
termediate Care, Acute Hospital Care, or Other Hospital Care from 
which the patient was admitted was operated as part of the license of 
some other hospital. 

(3) Not a Hospital. The site from which the patient was admitted was 
not operated under the license of a hospital. Includes all patients admitted 
from Home, Residential Care, Prison/Jail, and Other sites. Includes pa- 
tients admitted from Ambulatory Surgery or Skilled Nursing/Intermedi- 
ate Care sites that were not operated under the authority of the Hcense of 
any hospital. Excludes all patients admitted from Acute Hospital Care or 
Other Hospital Care. 

(c) Route of admission. 

( J ) Your Emergency Room. Any patient admitted as an inpatient after 
being treated or examined in this hospital's emergency room. Excludes 
patients seen in the emergency room of another hospital. 

(2) Not Your Emergency Room. Any patient admitted as an inpatient 
without being treated or examined in this hospital' s emergency room. In- 
cludes patients seen in the emergency room of some other hospital and 
patients not seen in any emergency room. 

NOTE: Authority cited:-Section 12881 0, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 10-14-93; operative 11-15-93 (Register 93, No. 42). 

2. Editorial correction of printing errors in subsection (a)(5) (Register 94, No. 17). 

3. Amendment of subsection (b), new subsections (c)-(c)(3)(B) and amendment 
of Note filed 7-15-96; operative 8-14-96 (Register 96, No. 29). 

4. Editorial correction of subsection (b)(1)(G) (Register 97, No. 19). 

5. Amendment filed 7-23-97 pursuant to section 100, title 1, California Code of 
Regulations (Register 97, No. 30). 

6. Repealer of subsections (a)-(a)(3)(B), subsection relettering, and amendment 
of remainder of secfion filed 9-21-98; operative 10-21-98 (Register 98, No. 
39). 

7. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 18). 



§ 97223. Definition of Data Element for Inpatients — Type of 
Admission. 

Effective with discharges on January 1, 1995, the patient's type of ad- 
mission shall be reported using one of the following categories: 

(a) Scheduled. Admission was arranged with the hospital at least 24 
hours prior to the admission. 

(b) Unscheduled. Admission was not arranged with the hospital at 
least 24 hours prior to the admission. 

(c) Infant. An infant less than 24 hours old. 

(d) Unknown. Nature of admission not known. Does not include still- 
births. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 10-14-93; operative 1 1-15-93 (Register 93, No. 42). 

2. Editorial correcfion of printing errors in subsections (a)(1) and (b) (Register 
94, No. 17). 

3. Amendment of section and Note filed 7-23-97 pursuant to section 100, fitle 1 , 
California Code of Regularions (Register 97, No. 30). 

4. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 18). 



§ 97224. Definition of Data Element for 
Inpatients — Discharge Date. 

The patient's date of discharge shall be reported in numeric form as 
follows: the 2-digit month, the 2-digit day, and the 4-digit year. The nu- 
meric form for days and months from J to 9 must have a zero as the first 
digit. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1 . New section filed 10-14-93; operative 1 1-15-93 (Register 93, No. 42). 

2. Amendment Note filed 7-23-97 pursuant to section 100. dtle 1, California 
Code of Regulafions (Register 97, No. 30). 

3. Amendment filed 9-21-98; operative 10-21-98 (Register 98, No. 39). 

4. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 18). 

§ 97225. Definition of Data Element for 

Inpatients — Principal Diagnosis and Whether 
the Condition was Present at Admission. 

(a) The patient's principal diagnosis, defined as the condition estab- 
lished, after study, to be the chief cause of the admission of the patient 
to the facihty for care, shall be coded according to the ICD-9-CM. 

(b) Effective with discharges on or after January 1 , 1996, whether the 
patient's principal diagnosis was present at admission shall be reported 
as one of the following: 

(l)Yes 

(2) No 

(3) Uncertain. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 10-14-93; operafive 11-15-93 (Register 93, No. 42). 

2. Amendment of section heading and secfion filed 1 1-27-95; operafive 1-1-96 
(Register 95, No. 48). 

3. Amendment of NOTE filed 7-23-97 pursuant to secfion 100, title 1, California 
Code of Regulations (Register 97, No. 30). 

4. Amendment of subsecfions (a) and (b) filed 9-21-98; operative 10-21-98 
(Register 98, No. 39). 

5. Amendment of secfion heading filed 5-5-2005; operafive 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 18). 

§ 97226. Definition of Data Element for Inpatients — Other 
Diagnoses and Whether the Conditions were 
Present at Admission. 

(a) The patient's other diagnoses are defined as all conditions that 
coexist at the time of admission, that develop subsequently during the 
hospital stay, or that affect the treatment received and/or the length of 
stay. Diagnoses that relate to an earlier episode that have no bearing on 
the current hospital stay are to be excluded. Diagnoses shall be coded ac- 
cording to the ICD-9-CM. ICD-9-CM codes from the Supplementary 
Classification of External Causes of Injury and Poisoning (E800-E999) 
and codes from Morphology of Neoplasms (M800-M997 codes) shall 
not be reported as other diagnoses. 

(b) Effective with discharges on or after January 1, 1996, whether the 
patient's other diagnoses were present at admission shall be reported as 
one of the following: 

(l)Yes 

(2) No 

(3) Uncertain. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New secfion filed 10-14-93; operafive 11-15-93 (Register 93, No. 42). 

2. Amendment of secfion heading and secfion filed 11-27-95; operative 1-1-96 
(Register 95, No. 48). 

3. Amendment of subsecfion (a) and Note filed 7-23-97 pursuant to secfion 100, 
title 1, California Code of Regulations (Register 97, No. 30). 

4. Amendment of subsections (a) and (b) filed 9-21-98; operafive 10-21-98 
(Register 98, No. 39). 



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5. Amendment of section heading and subsection (a) filed 5-5-2005; operative 
5-5-2005 pursuant to Government Code section 1 1343.4 (Register 2005, No. 
18). 



§ 97227. Definition of Data Element for 

Inpatients — External Cause of Injury. 

The external cause of injury consists of the 1CD-9-CM codes 
E800-E999 (E-codes), that are codes used to describe the external 
causes of injuries, poisonings, and adverse effects. If the information is 
available in the medical record, E-codes sufficient to describe the exter- 
nal causes shall be reported for records with a principal and/or other diag- 
noses classified as injuries or poisonings in Chapter 1 7 of the 1CD-9-CM 
(800-999), or where a code from Chapters 1-16 of the 1CD-9-CM 
(001-799) indicates that an additional E-code is applicable, except that 
the reporting of E-codes in the range E870-E879 (misadventures and ab- 
normal reactions) are not required to be reported. An E-code is to be re- 
ported on the record for the first episode of care reportable to the Office 
during which the injury, poisoning, and/or adverse effect was diagnosed 
and/or treated. If the E-code has been previously reported on a discharge 
or encounter record to the Office, the E-code should not be reported 
again on the discharge record. To assure uniform reporting of E-codes, 
when multiple codes are required to completely classify the cause, the 
first (principal) E-code shall describe the mechanism that resulted in the 
most severe injury, poisoning, or adverse effect. If the principal E-code 
does not include a description of the place of occurrence of the most se- 
vere injury or poisoning, an E-code shall be reported to designate the 
place of occurrence, if available in the medical record. Additional E- 
codes shall be reported, if necessary to completely describe the mecha- 
nisms that contributed to, or the causal events surrounding, any injury, 
poisoning, or adverse effect. 

NOTE; Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 10-14-93; operative 11-15-93 (Register 93, No. 42). 

2. Amendment of section and Note filed 7-23-97 pursuant to section 1 00, title 1 , 
California Code of Regulations (Register 97, No. 30). 

3. Amendment filed 9-21-98; operative 10-21-98 (Register 98, No. 39). 

4. Amendment of section heading and section filed 5-5-2005; operative 
5-5-2005 pursuant to Government Code section 1 1343.4 (Register 2005, No. 
18). 

5. Amendment filed 1 1-21-2006; operative 1 1-21-2006 pursuant to Government 
Code section 1 1343.4 (Register 2006, No. 47). 

§ 97228. Definition of Data Element for 

Inpatients — Principal Procedure and Date. 

The patient's principal procedure is defined as one that was performed 
for definitive treatment rather than one performed for diagnostic or ex- 
ploratory purposes, or was necessary to take care of a complication. If 
there appear to be two procedures that are principal, then the one most 
related to the principal diagnosis should be selected as the principal pro- 
cedure. Procedures shall be coded according to the ICD-9-CM. If only 
non-therapeutic procedures were performed, then a non-therapeutic 
procedure should be reported as the principal procedure, if it was a signif- 
icant procedure. A significant procedure is one that is surgical in nature, 
or carries a procedural risk, or carries an anesthetic risk, or is needed for 
DRG assignment. The date the principal procedure was performed shall 
be reported in numeric form as follows: the 2-digit month, the 2-digit 
day and the 4-digit year. The numeric form for days and months from 1 
to 9 must have a zero as the first digit. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 10-14-93; operative 11-15-93 (Register 93, No. 42). 

2. Amendment of Note filed 7-23-97 pursuant to section 100, title 1, California 
Code of Regulations (Register 97, No. 30). 

3. Amendment filed 9-21-98; operative 10-21-98 (Register 98, No. 39). 

4. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 11343.4 (Register 2005, No. 18). 



§ 97229. Definition of Data Element for Inpatients— Other 
Procedures and Dates. 

All significant procedures are to be reported. A significant procedure 
is one that is surgical in nature, or carries a procedural risk, or carries an 
anesthetic risk, or is needed for DRG assignment. Procedures shall be 
coded according to the ICD-9-CM. The dates shall be recorded with the 
corresponding other procedures and be reported in numeric form as fol- 
lows: the 2-digit month, the 2-digit day, and the 4-digit year. The numer- 
ic form for days and months from 1 to 9 must have a zero as the first digit. 
NOTE: Authority cited: Section 1 28810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 10-14-93; operative 11-15-93 (Register93, No. 42). 

2. Amendment of Note filed 7-23-97 pursuant to section 1 00, title 1 , California 
Code of Reguiafions (Register 97, No. 30). 

3. Amendment filed 9-21-98; operative 10-21-98 (Register 98, No. 39). 

4. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 11 343.4 (Register 2005, No. 18). 

§ 97230. Definition of Data Element for Inpatients— Total 
Charges. 

The total charges are defined as all charges for services rendered dur- 
ing the length of stay for patient care at the facility, based on the hospital' s 
full established rates. Charges shall include, but not be limited to, daily 
hospital services, ancillary services and any patient care services. Hospi- 
tal-based physician fees shall be excluded. Prepayment (e.g. deposits 
and prepaid admissions) shall not be deducted from Total Charges. If a 
patient's length of stay is more than I year (365 days), report Total 
Charges for the last year (365 days) of stay only. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 10-14-93; operative 11-15-93 (Register 93, No. 42). 

2. Amendment of Note filed 7-23-97 pursuant to section 100, title 1, California 
Code of Regulations (Register 97, No. 30). 

3. Amendment filed 9-21-98; operative 10-21-98 (Register 98, No. 39). 

4. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 18). 

§ 97231 . Definition of Data Element for 

Inpatients — Disposition of Patient. 

Effective with discharges on or after January 1 , 1997, the patient's dis- 
position, defined as the consequent arrangement or event ending a pa- 
tient's stay in the reporting facility, shall be reported as one of the follow- 
ing: 

(a) Routine Discharge. A patient discharged from this hospital to re- 
turn home or to another private residence. Padents scheduled for follow- 
up care at a physician's office or a clinic shall be included. Excludes pa- 
tients referred to a home health service. 

(b) Acute Care Within This Hospital. A patient discharged to inpatient 
hospital care that is of a medical/surgical nature, such as to a perinatal, 
pediatric, intensive care, coronary care, respiratory care, newborn inten- 
sive care, or bum unit within this reporting hospital. 

(c) Other Type of Hospital Care Within This Hospital. A patient dis- 
charged to inpatient hospital care not of a medical/surgical nature and not 
skilled nursing/intermediate care, such as to a psychiatric, physical medi- 
cine rehabilitation, or chemical dependency recovery treatment unit 
within this reporting hospital. 

(d) Skilled Nursing/Intermediate Care Within This Hospital. A pafient 
discharged to a Skilled Nursing/Intermediate Care Distinct Part within 
this reporfing hospital. 

(e) Acute Care at Another Hospital. A patient discharged to another 
hospital to receive inpatient care that is of a medical/surgical nature, such 
as to a perinatal, pediatric, intensive care, coronary care, respiratory care, 
newborn intensive care, or bum unit of another hospital. 

(f) Other Type of Hospital Care at Another Hospital. A patient dis- 
charged to another hospital to receive inpatient hospital care not of a 
medical/surgical nature and not skilled nursing/intermediate care, such 
as to a psychiatric, physical medicine rehabilitation, or chemical depen- 
dency recovery treatment unit of another hospital. 



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Title 22 



(g) Skilled Nursing/Intermediate Care Elsewhere. A patient dis- 
charged from this hospital to a Skilled Nursing/Intermediate Care type 
of care, either freestanding or a distinct part within another hospital, or 
to a Congregate Living Health Facility as defined by Subsection (i) of 
Section 1250 of the Health and Safety Code. 

(h) Residential Care Facility. A patient discharged to a facility that 
provides special assistance to its residents in activities of daily living, but 
that provides no organized health care. 

(i) Prison/Jail. A patient discharged to a correctional institution. 

(j) Against Medical Advice. Patient left the hospital against medical 
advice without a physician's discharge order. Psychiatric patients dis- 
charged from away without leave (AWOL) status are included in this 
category. 

(k) Died. All episodes of inpatient care that terminated in death. Pa- 
tient expired after admission and before leaving the hospital. 

(/) Home Health Service. A patient referred to a licensed home health 
service program. 

(m) Other. A patient discharged to some place other than mentioned 
above. Includes patients discharged to a freestanding, not hospital- 
based, inpatient hospice facihty. 

NOTE: Authority cited: Section 12881 0, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 10-14-93; operative 1 1-15-93 (Register 93, No. 42). 

2. Amendment of subsection (b), new subsections (c)-(c)(13) and amendment of 
Note filed 7-15-96; operative 8-14-96 (Register 96, No. 29). 

3. Amendment filed 7-23-97 pursuant to section 100, title 1, California Code of 
Regulations (Register 97, No. 30). 

4. Repealer of subsections (a)-(a)(13), subsection relettering, and amendment of 
remainder of section filed 9-21-98; operative 10-21-98 (Register 98, No. 39). 

5. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 1 8). 



§ 97232. Definition of Data Element for 

Inpatients — Expected Source of Payment. 

(a) Effective with discharges on or after January 1 , 1999, the patient's 
expected source of payment shall be reported using the following: 

(1) Payer Category: The type of entity or organization which is ex- 
pected to pay or did pay the greatest share of the patient's bill. 

(A) Medicare. A federally administered third party reimbursement 
program authorized by Title XVIII of the Social Security Act. Includes 
crossovers to secondary payers. 

(B) Medi-Cal. A state administered third party reimbursement pro- 
gram authorized by Title XIX of the Social Security Act. 

(C) Private Coverage. Payment covered by private, non-profit, or 
commercial health plans, whether insurance or other coverage, or organi- 
zations. Included are payments by local or organized charities, such as 
the Cerebral Palsy Foundation, Easter Seals, March of Dimes, or Shrin- 
ers. 

(D) Workers' Compensation. Payment from workers' compensation 
insurance, government or privately sponsored. 

(E) County Indigent Programs. Patients covered under Welfare and In- 
stitutions Code Section 17000. Includes programs funded in whole or in 
part by County Medical Services Program (CMSP), California Health- 
care for Indigents Program (CHIP), and/or Realignment Funds whether 
or not a bill is rendered. 

(F) Other Government. Any form of payment from government agen- 
cies, whether local, state, federal, or foreign, except those in Subsections 
(a)(1)(A), (a)(1)(B), (a)(1)(D), or (a)(1)(E) ofthis section. Includes funds 
received through the California Children Services (CCS), the Civilian 
Health and Medical Program of the Uniformed Services (TRICARE), 
and the Veterans Administration. 

(G) Other Indigent. Patients receiving care pursuant to Hill-Burton 
obligations or who meet the standards for charity care pursuant to the 
hospital's established charity care policy. Includes indigent patients, ex- 
cept those described in Subsection (a)(1)(E) ofthis section. 



(H) Self Pay. Payment directly by the patient, personal guarantor, rela- 
tives, or friends. The greatest share of the patient's bill is not expected to 
be paid by any form of insurance or other health plan. 

(1) Other Payer. Any third party payment not included in Subsections 
(a)(1)(A) through (a)(1)(H) ofthis section. Included are cases where no 
payment will be required by the facility, such as special research or cour- 
tesy patients. 

(2) Type of Coverage. For each Payer Category, Subsections (a)(1)(A) 
through (a)(1)(F) of this section, select one of the following Types of 
Coverage: 

(A) Managed Care — Knox-Keene/Medi-Cal County Organized 
Health Systein. Health care service plans, including Health Maintenance 
Organizations (HMO), licensed by the Department of Corporations un- 
der the Knox-Keene Health Care Service Plan Act of 1975. Includes 
Medi-Cal County Organized Health Systems. 

(B) Managed Care — Other. Health care plans, except those in Subsec- 
tion (a)(2)(A) ofthis section, which provide managed care to enrollees 
through a panel of providers on a pre-negotiated or per diem basis, usual- 
ly involving utilization review. Includes Preferred Provider Organization 
(PPO), Exclusive Provider Organization (EPO), Exclusive Provider Or- 
ganization with Point-of-Service option (POS). 

(C) Traditional Coverage. All other forms of health care coverage, in- 
cluding the Medicare prospective payment system, indemnity or fee- 
for-service plans, or other fee-for-service payers. 

(3) Name of Plan. 

(A) For discharges occurring on or after January 1. 2004, report the 
names of those plans which are licensed under the Knox-Keene Health 
Care Service Plan Act of 1 975 or designated as a Medi-Cal County Orga- 
nized Health System. For Type of Coverage, Subsection (a)(2)(A) ofthis 
section, report the plan code number representing the name of the Knox- 
Keene licensed plan or the Medi-Cal County Organized Health System 
as shown in Table 1 . 

Table 1. Plan Code Numbers for Knox-Keene Licensed Plans and 

Medi-Cal County Organized Health Systems: 

For use with discharges occurring on or after January 1, 2004 

Plan Names and Medi-Cal County 
Organized Health System Names Plan Code Numbers 

AET Health Care Plan of California 0296 

Aetna Health Plans of California, Inc. 0176 

Alameda Alliance for Health 0328 

American Family Care 0322 

Avante Behavioral Health Plan 0397 

Blue Cross of California 0303 

Blue Shield of California 0043 

Caloptima (Orange County) 0394 

Care 1st Health Plan 0326 

CareMore Insurance Services, Inc. 0408 

Cedars-Sinai Provider Plan, LLC 0366 
Central Coast Alliance For Health (Santa 

Cruz County/Monterey County) 0401 

Central Health Plan 0404 

Chinese Community Health Plan 0278 

Cigna Behavioral Health of California 0298 

Cigna Healthcare of California, Inc. 0152 

Community Health Group 0200 

Community Health Plan (County of Los Angeles) 0248 

Contra Costa Health Plan 0054 

HAI, Hai-Ca 0292 

Health Net of California, Inc. 0300 

Health Plan of America (HPA) 01 26 

Health Plan of the Redwoods 0159 

(The) Health Plan of San Joaquin 0338 

Health Plan of San Mateo 0358 

Heritage Provider Network, Inc. 0357 

HHRC, Integrated Insights 03 1 9 

Holman Professional Counseling Centers 0231 



Page 1244 



Register 2006, No. 47; 11-24-2006 



Title 22 



Health Planning and Facility Construction 



§ 97240 



• 



Plan Names and Medi~Cal County- 
Organized Health System Names 
Inland Empire Health Plan (lEHP) 
Inter Valley Health Plan 
Kaiser Foundation Health Plan, Inc. 
Kern Health Systems Inc. 
Lifeguard, Inc. 
LA Care Health Plan 
Managed Health Network 
Medcore HP 

Merit Behavioral Care of California, Inc. (MBC) 
Molina Healthcare of California 
One Health Plan of California Inc. 
On Lok Senior Health Services 
PacifiCare Behavioral Health of California 
PacifiCare of California 
Primecare Medical Network, Inc. 
ProMed Health Care Administrators 
Regents of the University of California 
San Francisco Health Plan 
Santa Barbara Regional Health Authority 
Santa Clara Family Health Plan 
Santa Clara Valley Med. Ctr. 
SCAN Health Plan 

Scripps Clinic Health Plan Services, Inc. 
Secure Horizons 
Sharp Health Plan 
Simnsa Health Care 

Sistemas Medicos Nacionales, S.A. De C.V. 
Smartcare Health Plan 

Solano Partnership Health Plan (Solano County) 
The Health Plan of San Joaquin 
UHP Healthcare 
Universal Care 

U.S. Behavioral Health Plan, CaUfomia 
Valley Health Plan 
ValueOptions of California, Inc. 
Ventura County Health Care Plan 
Vista Behavioral Health Plan 
Western Health Advantage 
Other 



Plan Code Numbers 
0346 
0151 
0055 
0335 
0142 
0355 
0196 
0390 
0288 
0322 
0325 
0385 
0301 
0126 
0367 
0380 
0354 
0349 
0400 
0351 
0236 
0212 
0377 
0126 
0310 
0393 
0393 
0212 
9048 
0338 
0008 
0209 
0259 
0236 
0293 
0344 
0102 
0348 
8000 



(B) For discharges occurring on or after January 1, 2005 also include 
the additional plans listed. 

Table la. Additional Plan Code Numbers for Knox-Keene Licensed 

Plans and Medi-Cal County Organized Health Systems: 

For use with discharges occurring on or after January 1 , 2005 

Plan Names and Medi-Cal County 

Organized Health System Names Plan Code Numbers 

Blue Cross of California Partnership Plan 0415 

Great-West Healthcare of California, Inc. 0325 

Honored Citizens Choice Health Plan, Inc. 0414 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 10-14-93; operative 11-15-93 (Register 93, No. 42). 

2. Amendment filed 7-23-97 pursuant to secfion 100, title 1, California Code of 
Regulations (Register 97, No. 30). 

3. Amendment of section, including new subsection (a)(3)(A), filed 9-21-98; op- 
erative 10-21-98 (Register 98, No. 39). 

4. Editorial correction of HISTORY 3 (Register 2000, No. 20). 

5. Change without regulatory effect repealing subsections (a)-(a)(14), renumber- 
ing subsections, amending newly designated subsections (a)( !)(?), (a)(1)(G), 
(a)( 1 )(1), (a)(2), (a)(2)(B) and (a)(3)(A), and adopting new subsection (a)(2)(B) 
filed 5-17-2000 pursuant to section 100, title 1 , California Code of Regulations 
(Register 2000, No. 20). 

6. Change without regulatory effect repealing subsection (a)(3)(A), relettering 
subsections, amending newly designated subsecfion (a)(3)(A) and adopting 



new subsection (a)(3)(B) filed 3-8-2004 pursuant to section 100, title 1, 
California Code of Regulations (Register 2004, No. 1 1 ). 

7. Amendment of section heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 1 8). 

8. Change without regulatory effect amending subsection (a)(1)(C), repealing sub- 
section (a)(3)(A), relettering former subsection (a)(3)(B) to new subsection 
(a)(3XA) and adopting new subsection (a)(3)(B) filed 8-1 1-2005 pursuant to 
section 100, fitle 1, California Code of Regulations (Register 2005, No. 32). 

§ 97233. Definition of Data Element for 

Inpatients — Prehospital Care and 
Resuscitation. 

Effective with discharges on or after January 1, 1999, information 
about resuscitation orders in a patient's current medical record shall be 
reported as follows: 

(a) Yes, a DNR order was written at the time of or within the first 24 
hours of the patient's admission to the hospital. 

(b) No, a DNR order was not written at the time of or within the first 
24 hours of the patient's admission to the hospital. 

NoTE; Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New section filed 9-21-98; operative 10-21-98 (Register 98, No. 39). 

2. Amendment of secfion heading filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 18). 

§ 97239. Hospital Identification Number. 

NOTE: Authority cited: Secfion 128765, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. New secfion filed 10-14-93; operafive 1 1-15-93 (Register 93, No. 42). 

2. Amendment filed 7-23-97 pursuant to section 100, fifie 1, California Code of 
Regulations (Register 97, No. 30). 

3. Amendment filed 9-21-98; operafive 10-21-98 (Register 98, No. 39). 

4. Repealer filed 9-23-2003; operative 9-23-2003 pursuant to Government Code 
section 1 1343.4 (Register 2003, No. 39), 

§ 97240. Request for Modifications to Patient Data 
Reporting. 

(a) Reporting facilities may file a request with the Office for modifica- 
tions to Hospital Discharge Abstract Data, Emergency Care Data, or Am- 
bulatory Surgery Data reporting requirements. The modification request 
must be supported by a detailed justification of the hardship that full re- 
porting of data would have on the reporting facility; an explanation of at- 
tempts to meet data reporting requirements; and a description of any oth- 
er factors that might justify a modification. Modifications may be 
approved for only one year. Each reporting facility with an approved 
modification must request a renewal of that approval 60 days prior to ter- 
mination of the approval period in order to have the modification contin- 
ue in force. 

(b) The criteria to be considered and weighed by the Office in deter- 
mining whether a modification to data reporting requirements may be 
granted are as follows: 

(1) The modificafion would not impair the ability of either providers 
or consumers to make informed health care decisions. 

(2) The modification would not deprive the public of data needed to 
make comparative choices with respect to scope or type of services or to 
how services are provided, and with respect to the manner of payment. 

(3) The modification would not impair any of the goals of the Act. 

(c) Reporting facilities that did not have any discharges or encounters 
that are required to be reported pursuant to Section 9721 3(a) for a specific 
report period must complete and submit a separate No Data to Report 
form (OSHPD 2005.1) as Revised on 09/26/2005 on or before the re- 
quired due date of the report either by using the onhne screen available 
through the MIRCal system or by printing the online No Data to Report 
form and mailing or faxing it to the Office for that report period. 

(d) Any facility that is not licensed to provide inpafient care, or does 
not provide Emergency Care encounters, or does not provide outpatient 
procedures, or is not licensed as a surgical clinic, and from whom such 
reporting is not therefore expected, is not required to file a No Data to Re- 
port form. 



Page 1245 



Register 2006, No. 47; 11-24-2006 



§ 97241 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128735, 128736, 128737 and 128760, Health and Safety Code. 

History 

1. Renumbering and amendment of former section 97213 to new section 97240 
filed 10-14-93; operative 11-15-93 (Register 93, No. 42). 

2. Amendment of subsection (a) filed 7-23-97 pursuant to section 100, title 1 , Cal- 
ifornia Code of Regulations (Register 97, No. 30). 

3. Amendment of subsection (b)(2) filed 9-21 -98; operative 10-21-98 (Reeister 
98, No. 39). 

4. Amendment of section heading, section and Note filed 5-5-2005; operative 
5-5-2005 pursuant to Government Code section 1 1343.4 (Register 2005, No. 
18). 

5. New subsections (c)-(d) filed 1 1-2 1-2006; operative 1 1-2 1-2006 pursuant to 
Govemmenl Code section 1 1343.4 (Register 2006, No. 47). 

§ 97241 . Extensions of Time to File Reports. 

(a) Extensions are available to reporting facilities that are unable to 
complete the submission of reports by the due date prescribed in Section 
97211. 

(1) Requests for extension shall be filed on or before the required due 
date of the report by using the extension request screen available through 
the MIRCal system or by using the Patient Data Reporting Extension Re- 
quest (form DD1805) as revised 06/09/2005. Notices regarding the use 
of extension days, and new due dates, as well as notices of approval and 
rejection, will be e-mailed to the primary contact and Administrator e- 
mail addresses provided by the facility. If a Designated Agent e-mail 
contact address has been provided by the facility, this contact will also 
be notified. These notices will also be available to all facility MIRCal us- 
ers on the MIRCal Submission Status page. 

(2) The Oflice shall respond within 5 days of receipt of the request by 
either granting what is determined to be a reasonable extension or disap- 
proving the request. The Office shall not grant extensions that exceed the 
maximum number of days available for the report period for all exten- 
sions. If a reporting facihty submits the report prior to the due date of an 
extension, those days not used will be applied to the number of remaining 
extension days. A reporting facihty that wishes to contest any decision 
of the Office shall have the right to appeal, pursuant to Section 97052. 

(b) A maximum of 14 extension days will be allowed for all extensions 
and resubmittals of reports with discharges or encounters occurring on 
or after January 1, 2005. 

(c) If a report is rejected on, or within 7 days before, or at any time after, 
any due date established by Subsections (c), or (d), of Section 9721 1, the 
Office shall grant, if available, an extension of 7 days. If less than 7 days 
are available all available extension days will be granted. 

(d) If the Office determines that the MIRCal system was unavailable 
for data submission for one or more periods of 4 or more continuous sup- 
ported hours during the 4 State working days before a due date estab- 
lished pursuant to Section 9721 1 , the Office shall extend the due date by 
7 days. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128770, Health and Safety Code. 

History 

1. Renumbering and amendment of former section 97214 to new section 97241 
filed 10-14-93; operative 1 1-15-93 (Register 93, No. 42). 

2. Amendment of section and Note filed 7-23-97 pursuant to section 100, title I, 
California Code of Regulations (Register 97, No. 30). 

3. Amendment of last paragraph filed 9-21-98; operative 10-21-98 (Register 98, 

No. 39). 

4. Amendment of section heading and section filed 9-23-2003; operative 
9-23-2003 pursuant to Government Code section 1 1343.4 (Register 2003, No. 
39). 

5. Amendment of section heading, section and Note filed 5-5-2005; operative 
5-5-2005 pursuant to Government Code section 1 1343.4 (Register 2005, No. 
18). 

6. Change without regulatory effect repealing subsections (b) and (c) and reletter- 
ing subsections filed 8-11-2005 pursuant to section 100, title 1, California 
Code of Regulations (Register 2005, No. 32). 

7. Amendment of subsections (a)(1) and (a)(2), repealer of subsections 
(a)(l)(A)-(C) and amendment of Note filed 11-21-2006; operative 
11-21-2006 pursuant to Government Code section 11343.4 (Register 2006, 

No. 47). 



§ 97242. Error Tolerance Levels. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

HfSTORY 

1. Renumbering and amendment of former section 97215 to new section 97242 
filed 10-14-93: operative 1 1-15-93 (Register 93, No. 42). 

2. Editorial correction of printing enors in tables 1 and 2 (Register 94, No. 17). 

3. Amendment of Tables 1 and 2, newly designated subsection (d)(5)(A) and new 
subsection (d)(5)(B) filed 1 J -27-95; operative 1-1-96 (Register 95, No. 48). 

4. Amendment of secfion and Note filed 7-23-97 pursuant to section 100, title 1, 
California Code of Regulations (Register 97, No. 30). 

5. Amendment of section, including repealer of table 2, filed 9-21-98; operative 
10-21-98 (Register 98, No. 39).^ 

6. Repealer filed 9-23-2003; operative 9-23-2003 pursuant to Government Code 
section 1 1343.4 (Register 2003, No. 39). 

§ 97243. Acceptance Criteria. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tion 128735, Health and Safety Code. 

History 

1. Renumbering and amendment of former section 97216 to new section 97243 
filed 10-14-93; operative 11-15-93 (Register 93, No. 42). 

2. Editorial correcfion of printing errors in subsection (b) (Register 94, No. 1 7). 

3. Amendment of section and Note filed 7-23-97 pursuant to section 100, title 1, 
California Code of Regulations (Register 97, No. 30). 

4. Amendment filed 9-21-98; operafive 10-21-98 (Register 98, No. 39). 

5. Repealer filed 9-23-2003; operative 9-23-2003 pursuant to Government Code 
section 1 1343.4 (Register 2003, No. 39). 

§ 97244. Method of Submission. 

(a) Reporting facilities shall use the MIRCal system for submitting re- 
ports. Data shall be reported utilizing a Microsoft Internet Explorer web 
browser that supports a secure Internet connection utilizing the Secure 
Hypertext Transfer Protocol (HTTPS or https) and 128-bit cypher 
strength Secure Socket Layer (SSL) through either: 

(1) Online transmission of data reports as electronic data files, or 

(2) Online entry of individual records. 

(b) For Hospital Discharge Abstract Data reports: If an approved ex- 
emption is on file with the Office, pursuant to Health and Safety Code 
Section 128755, a hospital may report discharges on or after January 1, 
2003 by diskette, compact disk or Hospital Discharge Abstract Data Re- 
cord Manual Abstract Reporting Form, provided the hospital complies 
with the Office's Format and File Specifications for MIRCal Online 
Transmission Patient Discharge Data as revised in April 2004. The ver- 
sion of the Manual Abstract Reponing Form (OSHPD 1370.IP) to be 
used is as revised on 03/17/2004. Copies of Form 1370. IP shall be made 
by the hospital to submit its discharge data and each additional copy shall 
be made on one sheet, front (Page 1 of 2) and back (Page 2 of 2). 

(c) For Emergency Care Data reports: If an approved exemption is on 
file with the Office, pursuant to Health and Safety Code Section 128755, 
a hospital may report encounters on or after October 1, 2004 by diskette, 
compact disk or Emergency Care Data Record Manual Abstract Report- 
ing Form (OSHPD 1370.ED), provided the hospital complies with the 
Office's Format and File Specificadons for MIRCal Online Transmis- 
sion Emergency Department and Ambulatory Surgery, dated January 
2006. The version of the Manual Abstract Reporting Form (1370.ED) to 
be used is dated 01/01/2006. Copies of Form 1370.ED shall be made by 
the hospital to submit its encounter data and each addil;ional copy shall 
be made on three sheets (Page 1 of 3), (Page 2 of 3), and (Page 3 of 3). 

(d) For Ambulatory Surgery Data reports: If an approved exemption 
is on file with the Office, pursuant to Health and Safety Code Section 
128755, a hospital or freestanding ambulatory surgery clinic may report 
encounters on or after October 1 , 2004 by diskette, compact disk or Am- 
bulatory Surgery Data Record Manual Abstract Reporting Form 
(OSHPD 1370. AS), provided the reporfing facility complies with the Of- 
fice's Format and File Specifications for MIRCal Online Transmission 
Emergency Department and Ambulatory Surgery, dated January 2006. 
The version of the Manual Abstract Reporting Form (1370.AS) to be 
used is dated 01/01/2006. Copies of Form 1370.AS shall be made by the 
hospital or freestanding ambulatory surgery clinic to submit its encounter 



Page 1246 



Register 2006, No. 47; 11-24-2006 



Title 22 



Health Planning and Facility Construction 



§ 97248 



• 



data and each additional copy shall be made on three sheets (Page 1 of 
3), (Page 2 of 3), and (Page 3 of 3). 

NOTE: Authority cited: Section 128755, Health and Safety Code. Reference: Sec- 
tions 128735, 128736 and 128737, Health and Safely Code. 

History 

1. New section filed 9-23-2003: operative 9-23-2003 pursuant to Government 
Code section 11343.4 (Register 2003, No. 39). 

2. Amendment of section and Note filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 18). 

3. Amendment of subsections (c)-(d) filed 11-21-2006; operative 11-21-2006 
pursuant to Government Code section 1 1343.4 (Register 2006, No. 47). 

§ 97245. Online Test Option. 

Reports may be tested before formal submission to the Office using the 
online test option. Online testing of reports through the MIRCal online 
test option before formal transmission is the recommended means of en- 
suring compliant data that meets the standards established by the Office 
before the due date. Reports tested through the online test option will be 
subject to the same processing and will generate the same reports as data 
that is formally submitted. Reports may be tested through the test option 
as many times as needed to assure that the reports meet the standards es- 
tablished by the Office in Section 97247. 

NOTE: Authority cited: Section 128755, Health and Safety Code. Reference: Sec- 
tions 128735, 128736 and 128737, Health and Safety Code. 

History 

1. New section filed 9-23-2003; operative 9-23-2003 pursuant to Government 
Code section 1 1343.4 (Register 2003, No. 39). 

2. Amendment of Note filed 5-5-2005; operative 5-5-2005 pursuant to Govern- 
ment Code section 11343.4 (Register 2005, No. 18). 

§ 97246. Data Transmittal Requirements. 

(a) Reporting facilities submitting their own data online must use the 
MIRCal Online Data Transmittal by Facility method to file or submit 
each report. The following information must be included: the facility 
name, the unique identification number specified in Section 97210, the 
beginning and ending dates of the report period, the number of records 
in the report and the following statement of certification: 

I certify under penalty of perjury that I am an official of this facility 
and am duly authorized to submit these data; and that, to the extent of my 
knowledge and information, the accompanying records are true and cor- 
rect, and that the applicable definitions of the data elements as set forth 
in Article 8 (Patient Data Reporting Requirements) of Chapter 10 (Health 
Facility Data) of Division 7 of Title 22 of in the California Code of Regu- 
lations, have been followed by this facility. 

(b) Reporting facilities that choose to designate an agent to submit 
their records must submit a hardcopy Agent Designation Form (OSHPD 
1370.3, Revised: 06/09/2005), hereby incorporated by reference, to the 
Office's Patient Data Program. Receipt of a subsequent hardcopy Agent 
Designation Form supercedes the previous designation. Each reporting 
facility shall notify the Office's Patient Data Program within 15 days af- 
ter any change in designated agent. 

(c) An agent who has been designated by a reporting facility to submit 
that facility's data online must use the MIRCal Online Data Transmittal 
by Agent method to file or submit reports. The following information 
must be included: the facility name, the facility identification number 
specified in Section 97210, the beginning and ending dates of the report 
period, and the number of records in the report. 

(d) Reporting facilities with an approved exemption to submit records 
using either Hospital Discharge Abstract Data Record Manual Abstract 
Reporting Forms (OSHPD 1370.IP, Revised: 03/17/2004). or Emergen- 
cy Care Data Record Manual Abstract Reporting Forms (OSHPD 
1370.ED dated 01/01/2006), or Ambulatory Surgery Data Record Manu- 
al Abstract Reporting Forms (OSHPD 1370. AS dated 01/01/2006), dis- 
kette, or compact disk, must submit a hardcopy Individual Facility Trans- 
mittal Form (OSHPD 1370.1, Revised: 06/09/2005), hereby 
incorporated by reference. The Individual Facility Transmittal Form 
shall accompany the report. 

(e) Agents who have been designated by a reporting facility to submit 
a facility's report in accordance with an approved exemption as de- 



scribed in (d) above must submit a hardcopy Designated Agent Transmit- 
tal Form (OSHPD 1370.2, Revised: 06/09/2005), hereby incorporated by 
reference. The Designated Agent Transmittal Form shall accompany the 
facility's report. 

(f) A facility's administrator may designate no more than 3 User Ac- 
count Administrators. For each User Account Administrator there must 
be an original signed Facility User Account Administrator Agreement 
Form (OSHPD 2002.1, Revised: 01/05/2006), and hereby incorporated 
by reference), subinitted to the Office. 

(g) A signed Designated Agent User Agreement Form (OSHPD 
2002.2, Revised: 01/05/2006), hereby incorporated by reference, must 
be submitted to the Office by an agent who has been designated to submit 
data online. 

(h) ReporUng facilities and designated agents may obtain copies of the 
forms from the OSHPD web site at www.oshpd.ca.gov or by contacting 
the Office's Patient Data Program at (916) 324-6147. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128735, 128736 and 128737, Health and Safety Code. 

History 

1. New section filed 9-23-2003; operative 9-23-2003 pursuant to Government 
Code section 11343.4 (Register 2003, No. 39). 

2. Amendment of section and Note filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code secfion 11343.4 (Register 2005, No. 18). 

3. Amendment of subsections (b) and (d)-(g) filed 11-21-2006; operative 
11-21-2006 pursuant to Government Code secfion 11343.4 (Register 2006, 
No. 47). 

§ 97247. Approval Criteria. 

(a) The following requirements must be met for a report to be approved 
by the Office: 

(1) Complete transmittal information must be submitted with each re- 
port. 

(2) Tlie facility identification number stated in the transmittal informa- 
tion must be consistent with the facility identification number on each of 
the records in the report. 

(3) The report period stated in the transmittal information must be con- 
sistent with all of the records in the report. 

(4) The number of records stated in the transmittal information must 
be consistent with the number of records contained in the report. 

(5) All records required to be reported pursuant to 97213(a) must be 
reported. 

(6) The data must be reported in compliance with the format specifica- 
tions in Secfion 97215. 

(7) The data must be at, or below, the Error Tolerance Level specified 
in Section 97248. 

(8) The data must be consistent with the reporting facility ' s anticipated 
trends and comparisons, except as in (A) below: 

(A) If data are correctly reported and yet are inconsistent with the re- 
porting facility's anticipated trends and comparisons, the reporfing facil- 
ity may submit to the Office a written explanation detailing why the data 
are correct as reported. The Office may determine, upon review, that it 
will approve a report. 

(9) Each report must contain only one type of record as specified in 
Subsecfions (1), (2), and (3) of Subsection (a) of Section 97213. 

(b) The Office shall approve or reject each report within 15 days of re- 
ceiving it. The report shall be considered not filed as of the date that the 
facility is nofified that the report is rejected. Notification of approval or 
rejection of any report submitted online shall not take more than 15 days 
unless there is a documented MIRCal system failure. 

Note: Authority cited: Secfions 128810 and 128755, Health and Safety Code. 

Reference: Sections 128735, 128736 and 128737, Health and Safety Code. 

History 

1. Amendment of subsecfions (a)(5), (a)(8) and (a)(8)(A), new subsection (a)(9) 
and amendment of Note filed 5-5-2005; operative 5-5-2005 pursuant to Gov- 
ernment Code section 1 1343.4 (Register 2005, No. 1 8). 

§ 97248. Error Tolerance Level. 

(a) The Error Tolerance Level (ETL) for data reported to the Office 
shall be no more than 2%. Errors as defined in Subsection (k) of Section 
97212, must be corrected to the ETL. 



Page 1247 



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§ 97249 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



(b) For hospital discharge abstract data reports that do not exceed the 
Error Tolerance Level specified in Subsection (a) of tliis Section, defaults 
will be as shown in Table 1. 

Table 1. Hospital Discharge Abstract Data Record Defaults 
Invalid Data Element Default 



Admission date 


delete record 


Discharge date 


delete record 


Principal Diagnosis 


799.9 


Conditions Present at Admission 




for Principal Diagnosis 


Yes 


All other data elements 


blank or zero 



(c) For emergency care data reports that do not exceed the Error Toler- 
ance Level specified in Subsection (a) of this Section, defaults will be as 
shown in Table 2. 

Table 2: Emergency Care Data Record Defaults 

Invalid Data Element Default 



Service date 
Principal Diagnosis 
All other data elements 



delete record 

799.9 

blank or zero 



(d) For ambulatory surgery data reports that do not exceed the Error 
Tolerance Level specified in Subsection (a) of this Section, defaults will 
be as shown in Table 3. 

Table 3: Ambulatory Surgery Data Record Defaults 

Invalid Data Element Default 



Service date 
Principal Diagnosis 
All other data elements 



delete record 
799.9 
blank or zero 



NOTE; Authority cited: Section 128755, Health and Safety Code. Reference: Sec- 
tions 128735, 128736 and 128737, Health and Safety Code. 

History 

1. New section filed 9-23-2003; operative 9-23-2003 pursuant to Government 
Code section 1 1343.4 (Register 2003, No. 39). 

2. Amendment of section and Note filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 18). 

§ 97249. Hours of Operation. 

The MIRCal System will be supported from 8:00 a.m. to 5:00 p.m., 
Monday through Friday (except for Official State Holidays). System 
maintenance may cause intermittent MIRCal system unavailability. 
Contact the Patient Data Program at (916) 324-6147 to report possible 
MIRCal transmission problems. 

NOTE: Authority cited: Section 128755, Health and Safety Code. Reference: Sec- 
tions 128735, 128736 and 128737, Health and Safety Code. 

History 

1. New section filed 9-23-2003; operative 9-23-2003 pursuant to Government 
Code section 11343.4 (Register 2003, No. 39). 

2. Amendment of section and Note filed 5-5-2005; operative 5-5-2005 pursuant 
to Government Code section 1 1343.4 (Register 2005, No. 18). 

§ 97250. Failure to File a Data Report. 

Any health facility which does not file any report completed as re- 
quired by this article is liable for a civil penalty of one hundred dollars 
($1 00) a day to be assessed and recovered in a civil action brought in the 
name of the people of the State of California by the Office for each day 
that the filing of the report is delayed, considering all approved exten- 
sions of the due date as provided in Section 97241. Assessed penalties 
may be appealed pursuant to Section 97052. Within fifteen days after the 
date the reports are due, the Office shall notify the health facility of re- 
ports not yet received, the amount of the liability, and potential future U- 
ability for failure to file reports when due. Sixty days after an original re- 
port due date as specified in Section 97211(c), the MIRCal system will 
close for that report period. No report for the period will be accepted after 
the MIRCal system closure. No additional penalties will accrue for out- 
standing reports after the MIRCal system closure for a report period. 
NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128735, 128736 and 128737, Health and Safety Code. 



History 

1. New section filed 9-23-2003: operative 9-23-2003 pursuant to Govemment 
Code section 1 1343.4 (Register 2003, No. 39). 

2. Amendment of section heading and Note filed 5-5-2005; operative 5-5-2005 
pursuant to Government Code section 1 1343.4 (Register 2005, No. 18). 

3. Amendmentfiled 1 1-21-2006: operative 1 1-21-2006 pursuant to Govemment 
Code section 1 1 343.4 (Register 2006, No. 47). 

§ 97251 . Definition of Data Element for ED and AS— Date 
of Birth. 

(a) For online transmission of data reports as electronic data files, the 
patient's date of birth shall be reported in numeric form as follows: the 
4— digit year, the 2-digit month, and the 2-digit day. The numeric form 
for days and months from 1 to 9 must have a zero as the first digit. 

(b) For online entry of individual records, the patient's date of birth 
shall be reported in numeric form as follows: the 2-digit inonth, the 
2-digit day, and the 4-digit year. The numeric form for days and months 
from 1 to 9 must have a zero as the first digit. 

(c) When the complete date of birth is unknown, as much of the date 
as is known shall be reported. At a minimum, an approximate year of 
birth shall be reported. If only the age is known, the estiiTiated year of 
birth shall be reported and the month and day can be reported as 01 for 
month and 01 for day. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 

History 

1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Govemment 
Code section 1 1343.4 (Register 2005, No. 18). 

§ 97252. Definition of Data Element for ED and AS— Sex. 

The patient's gender shall be reported as male, female or unknown. 
Unknown indicates that the patient's sex was undetermined or not avail- 
able from the medical record. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code 

History 
1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Govemment 

Code section 11343.4 (Register 2005, No. 18). 

§ 97253. Definition of Data Element for ED and AS— Race. 

The race shall be as self-reported by the patient or patient's guardian 
in cases where the patient is not capable of providing the information. 
The patient's race shall be reported as one choice from the following list 
of alternatives under race: 

(a) American Indian or Alaska Native 

(b) Asian 

(c) Black or African American 

(d) Native Hawaiian or Other Pacific Islander 

(e) White 

(f) Other Race 

(g) Unknown 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 

History 

1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Govemment 
Code secfion 1 1343.4 (Register 2005, No. 18). 

§ 97254. Definition of Data Element for ED and 
AS— Ethnicity. 

The ethnicity shall be as self-reported by the patient or patient's 
guardian in cases where the patient is not capable of providing the in- 
formation. The patient's ethnicity shall be reported as one choice from 
the following list of alternatives under ethnicity: 

(a) Hispanic or Latino Ethnicity 

(b) Non-Hispanic or Non-Latino Ethnicity 

(c) Unknown 

NOTE: Authority cited: SecUon 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 

History 
1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Govemment 
Code section 11343.4 (Register 2005, No. 18). 



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Title 22 



Health Planning and Facility Construction 



§ 97262 



§ 97255. Definition of Data Element for ED and AS— ZIP 
Code. 

The "ZIP Code," a unique code assigned to a specific geographic area 
by the U.S. Postal Service, for the patient's usual residence shall be re- 
ported for each record. If the patient has a 9-digit ZIP Code, only the first 
five digits shall be reported. Do not report the ZIP Code of the hospital, 
third party payer, or billing address if it is different from the usual resi- 
dence of the patient. If the patient's ZIP Code is not recorded in the pa- 
tient's medical record, the patient's ZIP Code shall be reported as "not 
in medical record," by reporting the unknown ZIP Code as "99999." 
NOTE; Authority cited: Section 1 28810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 

History 
1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Government 

Code section 11343.4 (Register 2005, No. 18). 

§ 97256. Definition of Data Element for ED and 
AS — Patient Social Security Number. 

The patient's social security number is to be reported as a 9-digit num- 
ber. If the patient's social security number is not recorded in the patient's 
medical record, the social security number shall be reported as "not in 
medical record," by reporting the social security number as 
"000000001." The number to be reported is to be the patient's social se- 
curity number, not the social security number of some other person, such 
as the mother of a newborn or the insurance beneficiary under whose ac- 
count the hospital's bill is to be submitted. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 

History 
1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Government 

Code section 11343.4 (Register 2005, No. 18). 

§ 97257. Definition of Data Element for ED and 
AS— Service Date. 

(a) For online transmission of data reports as electronic data files, the 
patient's service date shall be reported in numeric form as follows: the 
4— digit year, the 2-digit month, and the 2-digit day. The numeric form 
for days and months from 1 to 9 must have a zero as the first digit. 

(b) For online entry of individual records, the patient's service date 
shall be reported in numeric form as follows: the 2-digit month, the 
2-digit day, and the 4-digit year. The numeric form for days and months 
from 1 to 9 must have a zero as the first digit. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 

History 
1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Government 
Code section 1 1343.4 (Register 2005, No. 18). 

§ 97258. Definition of Data Element for ED and 
AS — Principal Diagnosis. 

The patient's principal diagnosis, defined as the condition, problem, 
or other reason established to be the chief cause of the encounter for care, 
shall be coded according to the ICD-9-CM. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 

History 

1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Government 
Code section 1 1343.4 (Register 2005, No. 18). 

§ 97259. Definition of Data Element for ED and AS— Other 
Diagnoses. 

The patient's other diagnoses are defined as all conditions that coexist 
at the time of the encounter for emergency or ambulatory surgery care, 
that develop subsequently during the encounter, or that affect the treat- 
ment received. Diagnoses shall be coded according to the ICD-9-CM. 
ICD-9-CM codes from the Supplementary Classification of External 
Causes of Injury and Poisoning (E80O-E999) and codes from Morpholo- 
gy of Neoplasms (M800-M997 codes) shall not be reported as other 
diagnoses. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 



History 

1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Government 
Code section 1 1 343.4 (Register 2005, No. 1 8). 

§ 97260. Definition of Data Element for ED and 

AS — Principal External Cause of Injury. 

The external cause of injury consists of the ICD-9-CM codes 
E8()0-E999 (E-codes), that are codes used to describe external causes of 
injuries, poisonings, and adverse effects. If the information is available 
in the medical record, E-codes sufficient to describe the external causes 
shall be reported on records with a principal and/or other diagnoses clas- 
sified as injuries or poisonings in Chapter 17 of the ICD-9-CM 
(800-999), or where a code from Chapters 1-16 of the ICD-9-CM 
(001-799) indicates that an E-code is applicable, except that the report- 
ing of E-codes in the range E870-E879 (misadventures and abnormal 
reactions) are not required to be reported. An E-code is to be reported on 
the record for the first episode of care reportable to the Office during 
which the injury, poisoning, and/or adverse effect was diagnosed and/or 
treated. If the E-code has been previously reported on a discharge or en- 
counter record to the Office, the E-code should not be reported again on 
the encounter record. To assure uniform reporting of E-codes, when 
multiple codes are required to completely classify the cause, the first 
(principal) E-code shall describe the mechanism that resulted in the most 
severe injury, poisoning, or adverse effect. 

NOTE; Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 

History 

1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Government 
Code section 11343.4 (Register 2005, No. 18). 

2. Amendmentfiled 1 1-21-2006; operaUve 11 -2 1-2006 pursuant to Government 
Code section 11343.4 (Register 2006, No. 47). 

§ 97261 . Definition of Data Element for ED and AS— Other 
External Cause of Injury. 

The external cause of injury consists of the ICD-9-CM codes 
E8()0-E999 (E-codes), that are codes used to describe the external 
causes of injuries, poisonings, and adverse effects. If the information is 
available in the medical record, E-codes sufficient to describe the exter- 
nal causes shall be reported for records with a principal and/or other diag- 
noses classified as injuries or poisonings in Chapter 1 7 of the ICD-9-CM 
(800-999), or where a code from Chapters 1-16 of the ICD-9-CM 
(001-799) indicates that an additional E-code is applicable, except that 
the reporting of E-codes in the range E870-E879 (misadventures and ab- 
normal reactions) are not required to be reported. An E-code is to be re- 
ported on the record for the first episode of care reportable to the Office 
during which the injury, poisoning, and/or adverse effect was first diag- 
nosed and/or treated. If the E-code has been previously reported on a dis- 
charge or encounter record to the Office, the E-code should not be re- 
ported again on the encounter record. If the principal E-code does not 
include a description of the place of occurrence of the most severe injury 
or poisoning, an E-code shall be reported to designate the place of occur- 
rence, if available in the medical record. Additional E-codes shall be re- 
ported, if necessary to completely describe the mechanisms that contrib- 
uted to, or the causal events surrounding, any injury, poisoning, or 
adverse effect. 

NOTE; Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code 

History 

1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Government 
Code secfion 11343.4 (Register 2005, No. 18). 

2. Amendment filed 1 1-21-2006; operative 1 1-21-2006 pursuant to Government 
Code secfion 11343.4 (Register 2006, No. 47). 

§ 97262. Definition of Data Element for ED and 
AS — Principal Procedure. 

The patient's principal procedure is one that is surgical in nature, or 
carries a procedural risk, or carries an anesthetic risk. The procedure re- 
lated to the principal diagnosis, as the chief reason for the encounter, shall 
be selected as the principal procedure. The procedure shall be coded ac- 
cording to the Current Procedural Terminology, Fourth Edition (CPT-4). 
NOTE; Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 



Page 1249 



Register 2006, No. 47; 11-24-2006 



§ 97263 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



History 

1. New section filed 5-5-2005; operative 5-5-2005 piiisuant to Government 
Code section ] 1343.4 (Register 2005, No. 18). 

§ 97263. Definition of Data Element for ED and AS— Other 
Procedures. 

All significant procedures are to be reported. A significant procedure 
is one that is surgical in nature, or carries a procedural risk, or carries an 
anesthetic risk. Procedures shall be coded according to the Current Pro- 
cedural Terminology. Fourth Edition (CPT-4). 

NOTE; Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 

History 
1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Government 

Code section 1 1343.4 (Register 2005, No. 18). 

§ 97264. Definition of Data Element for ED and 
AS — Disposition of Patient. 

The patient's disposition, defined as the consequent arrangement or 
event ending a patient's encounter in the reporting facility, shall be re- 
ported as one of the following: 

(a) Discharged to home or self care (routine discharge). 

(b) Discharged/Transferred to a short-term general hospital for inpa- 
tient care 

(c) Discharged/Transferred to a skilled nursing facility (SNF) with 
Medicare certification in anticipation of covered skilled care. 

(d) Discharged/Transferred to an intermediate care facility (ICF). 

(e) Discharged/Transferred to another type of institution not defined 
elsewhere in this code list. 

(0 Discharged/Transferred to home under care of an organized home 
health service organization in anticipation of covered skilled care. 

(g) Left against medical advice or discontinued care. 

(h) Expired. 

(i) Discharged/Transferred to a Federal health care facility. 

(j) Discharged home with hospice care. 

(k) Discharged to a medical facility with hospice care. 

(/) Discharged/Transferred to a hospital-based Medicare approved 
swing bed. 

(m) Discharged/Transferred to an inpatient rehabilitation facility 
(IRF) including a rehabilitation distinct part unit of a hospital. 

(n) Discharged/Transferred to a Medicare certified long term care hos- 
pital (LTCH). 

(o) Discharged/Transferred to a nursing facility certified under Medic- 
aid (Medi-Cal), but not certified under Medicare. 

(p) Discharged/Transferred to a psychiatric hospital or psychiatric dis- 
tinct part unit of a hospital. 

(q) Discharged/Transferred to a Critical Access Hospital (CAH). 

(r) Other. 
Note: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 

History 

1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Government 
Code section 1 1 343.4 (Register 2005, No. 18). 

2. Amendment of subsections (c), (e) and (f), repealer of subsection (h), subsection 
relettering and repealer and new subsection (q) filed 11-21-2006; operative 
11-21-2006 pursuant to Government Code section 11343.4 (Register 2006, 
No. 47). 

§ 97265. Definition of Data Element for ED and 
AS — Expected Source of Payment. 

The patient's expected source of payment, defined as the type of entity 
or organization which is expected to pay or did pay the greatest share of 
the patient's bill, shall be reported using the following categories: 

(a) Self-pay. Payment directly by the patient, guarantor, relatives or 
friends. The greatest share of the patient's bill is not expected to be paid 
by any form of insurance or other third party. 

(b) Other Non-Federal Programs. Include any form of payment from 
local, county, or state government agencies. Include payments from 
county funds, whether from county general funds or from other funds 
used to support county health programs. Include County Indigent Pro- 



grams, County Medical Services Program (CMSP), California Health- 
care for Indigent Program (CHIP), County Children's Health Initiative 
Program (C-CHIP), and Short-Doyle funds. Also include the State Chil- 
dren's Health Insurance Program (SCHIP), Managed Risk Medical In- 
surance Board (MRMIB), Healthy Families Program (HFP), and Access 
for Infants and Mothers (AIM). 

(c) Preferred Provider Organization (PPO). 

(d) Point of Service (POS). 

(e) Exclusive Provider Organization (EPO). 

(f) Health Maintenance Organization (HMO) Medicare Risk. Medi- 
care is defined by Title XVIII of the Social Security Act (42 USC 1395 
et seq.) and Title 1 of the Federal Medicare Act (PL 89-97). Include 
Medicare patients covered under an HMO arrangement. 

(g) Automobile Medical. Include PPO, POS, EPO, HMO and Fee for 
Service or any other payment resulting from automobile coverage. 

(h) Blue Cross/Blue Shield. Include only Fee for Service payments. 
Report PPO, POS, EPO, and HMO under the appropriate stated catego- 
ries. 

(i) CHAMPUS (TRICARE). Include any PPO, POS, EPO, HMO, Fee 
for Service, or other payment from the Civilian Health and Medical Pro- 
gram of the Uniformed Services or from TRICARE. 

(j) Commercial Insurance Company. Report payment from insurance 
carriers on a Fee for Service basis. Exclude PPO, POS, and EPO, pay- 
ments. 

(k) Disability. 

(/) Health Maintenance Organization (HMO). Report HMO payors. 
Include Knox-Keene licensed plans as well as out of State HMO plans. 
No Plan Code Number or Plan Code Name is required for ED or AS re- 
cords. Report Medicare payments covered under an HMO arrangement 
as Health Maintenance Organization (HMO) Medicare Risk. Report 
Medi-Cal payments covered under an HMO arrangement as Medicaid. 

(m) Medicare Part A. Defined by Title XVIII of the Social Security 
Act. Covers inpatient hospital stays, care in a skilled nursing facility, hos- 
pice care, and some home health care. 

(n) Medicare Part B. Defined by Title XVIII of the Social Security Act. 
Covers some outpatient hospital care and some home health services. 

(o) Medicaid. Medicaid is called Medi-Cal in California. Defined by 
Title XIX of the Social Security Act and Title I of the Federal Medicare 
Act (PL 89-97). Report all Medi-Cal including Fee for Service, PPO, 
POS, EPO, and HMO. 

(p) Other Federal Program. Report federal programs not covered by 
any other category. 

(q) Title V. Defined by the Federal Medicare Act (PL 89-97) for Ma- 
ternal and Child Health. Title V of the Social Security Act is administered 
by the Health Resources and Services Administration, Public Health Ser- 
vice, Department of Health and Human Services. Include a Maternal and 
Child Health program payment that is not covered under Medicaid 
(Medi-Cal). California Children Services (CCS) payments should be re- 
ported here. 

(r) Veterans Affairs Plan. Include any PPO, POS, EPO, HMO, Fee for 
Service, or other payment resulting from Veterans Administration cover- 
age. 

(s) Workers' Compensation Health Claim. Payment from Workers' 
Compensation Health Claim insurance should be reported under this 
category. 

(t) Other. Include payment by governments of other countries. Include 
payment by local or organized charities, such as the Cerebral Palsy 
Foundation, Easter Seals, March of Dimes, Shriners, etc. Include pay- 
ments not listed in other categories. 

NOTE: Authority cited: Section 128810, Health and Safety Code. Reference: Sec- 
tions 128736 and 128737, Health and Safety Code. 

History 
1. New section filed 5-5-2005; operative 5-5-2005 pursuant to Government 
Code section 11343.4 (Register 2005, No. 18). 

§ 97266. Freestanding Ambulatory Surgery Encounter Fee 
Assessment. 

(a) The Office shall mail an annual notice of special fee assessment, 
as provided in Section 90417, and a remittance advice form to each free- 



Page 1250 



Register 2006, No. 47; 11-24-2006 



Title 22 



Health Planning and Facility Construction 



§ 97300.17 



standing ambulatory surgery clinic. The annual notice of special fee as- 
sessment and remittance advice form shall be mailed at least 20 days be- 
fore the fee due date. The remittance advice form shall be completed by 
each surgical clinic and returned to the Office with full payment of the 
special fee amount. The fee shall be due on July 1st and delinquent on 
July 31 St of each year. The basis of assessment is the number of ambula- 
tory surgery data records submitted to the Office for encounters in the 
preceding calendar year. 

(b) New surgical clinics which had no encounters in the previous cal- 
endar year are not liable for the initial special fee. 

(c) New surgical clinics that have been operating for less than 12 
months in the previous calendar year are liable for the special fee based 
on the number of ambulatory surgery data records submitted to the Office 
for encounters during the period of their licensed operations in the pre- 
vious calendar year. 

(d) Where there was a change in licensee during the prior calendar 
year, the current licensee shall be assessed a special fee based on the num- 
ber of ambulatory surgery data records submitted to the Office for en- 
counters that occurred during the time of their licensure. 

(e) The Office shall determine the basis of assessment for special fee 
amounts due from surgical clinics in those circumstances not specifically 
covered above. 

(f) To enforce payment of delinquent special fees, the Office shall 
notify the State Department of Health Services not to issue a license and 
not to renew the existing license of the delinquent surgical clinic until the 
special fees have been paid, pursuant to Section 127280, Health and 
Safety Code. A copy of the Office notice to the State Department of 
Health Services shall be sent to the delinquent surgical clinic. 

NOTE: Authority cited: Sections 127150, 127280 and 128810, Health and Safety 
Code. Reference: Sections 127280 and 128737, Health and Safety Code. 

History 
] . New section filed 1 1-21-2006; operative 1 1-21-2006 pursuant to Government 
Code section 11343.4 (Register 2006, No. 47). 



Chapter 1 1 . Alzheimer's Disease Institute 
Demonstration Project 

(Interim Regulations) 



Subchapter 1. Definitions 

§ 97300.1 . Accredited Record Technician. 

Accredited record technician means a person who is accredited as such 
by the American Medical Record Association. 

NOTE: Authority cited: Sections 131 1.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New Chapter 11 (Subchapters 1-13, Sections 97300.1-97434.9, not consecu- 
tive) filed 4-6-87 as an emergency; effecfive upon filing. This chapter was 
adopted on an interim basis as authorized by Health and Safety Code Section 
1 3 12.7 and is repealed by operation of that same section effective 7-1-90 (Reg- 
ister 87, No. 15). 

§ 97300.3. Activity Leader. 

Activity leader means a person qualified by training and/or experience 
to develop and implement an activity program. 

NOTE; Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1 312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.5. Administrator. 

Administrator means that person who is appointed, in writing, by the 
governing body of the Institute to carry out the policies of the Institute, 
except in those Subchapters or Sections where the term is otherwise de- 
fined. 



Note: Authority cited: Sections i 3 11 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.7. Advertisement. 

Advertisement means a public notice used to create interest or induce 
purchase, including but not limited to television, radio, newspapers, tele- 
phone books, brochures and signs. 

NOTE: Authority cited: Secfions 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New secfion filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.9. All Settings. 

All settings means the physical spaces, buildings or environments in 
which treatment, care, or supervision is provided to Institute patients. 
NOTE: Authority cited: Secfions 13 1 1.5 and 1312.7, Health and Safety Code. Ref- 
erence; Secfion 1312, Health and Safety Code. 

History 
1 . New secfion filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.1 1 . Alzheimer's Disease Institute. 

An Alzheimer's Disease Institute is an entity, public or private, which 
has been designated as an Alzheimer's Disease Institute by the Office of 
Statewide Health Planning and Development. 

NOTE: Authority cited: Secfions 131 1 .5 and 1 3 12.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New section filed 4—6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.13. Alzheimer's Disease. 

Alzheimer's disease is a brain disorder characterized by a progressive 
dementia that occurs in middle or late life. The pathologic characteristics 
are degeneration of specific nerve cells, presence of neuritic plaques, and 
neurofibrillary tangles. 

NOTE: Authority cited: Secfions 131 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New section filed 4—6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97300.15. Ambulatory Patient. 

Ambulatory patient means a pafient who is able to leave a building un- 
assisted under emergency conditions. 

NOTE: Authority cited: Secfions 131 J. 5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4—6-87 as an emergency; effective upon fihng. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§97300.17. Arranged For. 

Services arranged for by the Institute are those services not provided 
directly by the Institute but provided to Institute patients, their families 
and/or caregivers pursuant to a contract or other written agreement be- 
tween the Institute and a provider of services or care or supervision. 

Note: Authority cited: Secfions 1 31 1 .5 and 13 12.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safely Code. 

History 
1. New section fi^Ied 4-6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 



Page 1251 



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§ 97300.19 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



tion ] 312.7 and is repealed by operation of that same section effective 7-1-90 
(Register87, No. 15). 

§ 97300.1 9. Art Therapist. 

Art therapist means a person who has a master' s degree in art therapy 
or in art education or psychology with major course work in art or art ther- 
apy, including an approved clinical internship in art therapy from an ac- 
credited college or university, and a person who is registered or eligible 
for registration as such with the American Art Therapy Association. 
NOTE: Authority cited: Sections 1 31 1 .5 and 1 3 12.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.21 . Attending Physician. 

Attending physician means a physician who is on the staff of the Insti- 
tute or who has staff privileges and who has the responsibility for medical 
care of an individual Institute patient. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref 

erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.23. Audioiogist. 

Audiologist means a person licensed as such by the California Board 
of Medical Quality Assurance or a person who has a master's degree in 
the field and is authorized to practice under the supervision of a licensed 
audiologist as outlined in Section 2530.5(f), Division 2, Chapter 5.3, Ar- 
ticle 1, of the Business and Professions Code. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 



History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312:7 and is repealed by operation of that same section effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.25. Autoclaving. 

Autoclaving means the process of sterilization by steam under pres- 
sure. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 31 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New secfion filed 4-6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.27. Authorized Representative. 

Authorized representative means a person authorized by law, by court 
order, or by a written statement signed by the patient, unless the patient 
has been legally deemed incompetent, to act on behalf of the patient. 
NOTE: Authority cited: Secfions 131 1 .5 and 1 312.7, Health and Safety Code. Ref 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.29. Biological. 

Biological means a product, virus, serum, toxin, antitoxin or analo- 
gous product derived from living matter, which is applicable to the pre- 
vention, treatment or cure of disease or injuries in humans. 
NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 



[The next page is 1255.] 



Page 1252 



Register 2006, No. 47; 11-24-2006 



Title 22 



Health Planning and Facility Construction 



§ 97300.55 



§97300.31. Caregivers. 

Caregivers means those individuals who are not employees of the In- 
stitute and who provide care in a home setting to patients with Alzheim- 
er's disease or related dementias. 

NOTE: Authority cited: Sections 1 3 1 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.33. Case Manager. 

The case manager means a person designated in writing by the Medi- 
cal Director to conduct case management for specifically assigned pa- 
tients who s a registered nurse licensed by the California Board of Regis- 
tered Nursing and with a minimum of a bachelor's degree in nursing or 
an individual with a master's degree in social work. 
NOTE: Authority cited : Section 1 3 11 .5 and 1 3 1 2.7 Health and Safety Code. Refer- 
ence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.35. Case Management. 

Case management means the continuous oversight and monitoring of 
the status of a patient and that patient's family and/or caregiver by one 
professional staff person. 

NOTE: Authority cited: Sections 1 31 1.5 and 13 12.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4—6-87 as an emergency; effecdve upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.37. Cleaning. 

Cleaning means the process employed to free a surface from dirt or 
other extraneous materials. 

NOTE: Authority cited: Secdons 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.39. Comprehensive Assessment. 

Comprehensive assessment means the process for determining the 
complete range of needs of the patient with Alzheimer's disease or a re- 
lated dementia and that person's family and/or caregivers. 
NOTE; Authority cited: Sections 131 1 .5 and 131 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.41 . Conservator. 

Conservator means a person appointed by a court to take care of the 
person, the property or both of a conservatee under Section 5350 et seq., 
of the Welfare and Institutions Code or under Section 1800 et seq., of the 
Probate Code. 

NOTE: Authority cited: Secdons 1311 .5 and 1312.7, Health and Safety Code. Ref 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecdve upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effecdve 7-1-90 
(Register 87, No. 15). 



§ 97300.43. Consultant. 

Consultant means a qualified person who gives professional advice or 
service, with or without remuneration. 

Note: Authority cited: Secdons 1311. 5 and 1 312.7, Health and Safety Code. Ref- 
erence: Secdon 1312, Health and Safety Code. 

History 

1. New secdon filed 4-6-87 as an emergency; effecdve upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
don 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.45. Continuum of Care. 

Continuum of care means a series of variations in levels of care or 
types of services. 

NOTE; Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.47. Controlled Drugs. 

Controlled drugs means those drugs covered under the Federal Com- 
prehensive Drug Abuse Prevention Control Act of 1970, as amended, or 
the California Uniform Controlled Substances Act. 

NOTE; Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.49. Coordinated Clinical Interventions. 

Coordinated cUnicaJ interventions means a series of chnical services 
arranged by the case manager and provided to the patient at the necessary 
time and place to meet the patient's needs. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 

(Register 87, No. 15). 

§ 97300.51 . Dance Therapist. 

Dance therapist means a person who has a master's degree in dance 
therapy including a clinical internship from an accredited college or uni- 
versity, or a person who is registered or eligible for registration as such 
by the American Dance Therapy Association. 

NOTE; Authority cited: Sections 131 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed bv operation of that same section effective 7-1-90 
(Register87, No. 15). 

§ 97300.53. Dangerous Drug. 

Dangerous drug means any drug defined as such in Section 421 1 of the 
Business and Professions Code. 

NOTE: Authority cited: Sections 131 1.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register87, No. 15). 

§ 97300.55. Decubitus Ulcer. 

Decubitus ulcer means an ulceration of skin and underlying tissue 

caused by pressure. 

NOTE; Authority cited: Sections 1 3 1 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 



Page 1255 



(4-1-90) 



§ 97300.57 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.57. Deficiency. 

Deficiency means noncompliance with these regulations. 
NOTE: Authority cited; Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87. No. 15). 

§ 97300.59. Defined. 

Defined means explained in writing. 
Note: Authority cited: Sections 1 311.5 and 1 31 2.7, Health and Safely Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
I. New section filed 4-6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1 312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97300.61. Dementia. 

Dementia means a global dechne in intellectual function in clear con- 
sciousness. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.63. Dentist. 

Dentist means a person licensed as such by the California Board of 
Dental Examiners. 

Note: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon fifing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operafion of that same section effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.65. Department. 

Department means the State Department of Health Services. 
NOTE: Authority cited: Secfions 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.67. Designation Certificate. 

Designation Certificate means the document issued by the Office au- 
thorizing the designee to operate as an Alzheimer's Disease Institute. 
NOTE: Authority cited: Sections 1311.5 and 131 2.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New secfion filed 4-6-87 as an emergency; effecfive upon fiUng. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register87, No. 15). 

§ 97300.69. Designee. 

Designee means the legal entity, corporation, joint venture, partner- 
ship or individual that has been designated by the Office to operate an In- 
stitute. 

NOTE: Authority cited: Secfions 131 1.5 and 1312.7,Healthand Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 



History 

1 . New secfion filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97300.71. Diagnostic Evaluation. 

Diagnostic evaluation means a biopsychosocial examination of the pa- 
tient including an assessment of the family and a home visit, as appropri- 
ate. 

NOTE: Authority cited: Sections 1 31 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New secfion filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.73. Dietetic Service— General. 

Dietetic service means a service organized, staffed and equipped to as- 
sure that food served to patients is safe, appetizing and provided for their 
nutritional needs. 

Note: Authority cited: Secfions 1311 .5 and 1 31 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same section effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.75. Dietetic Service Supervisor. 

Dietetic service supervisor means a person who meets one of the fol- 
lowing requirements: 

(a) Is a dietitian registered by the American Dietetic Association. 

(b) Has a bachelor's degree with major studies in food and nutrition, 
dietetics, or food management and has one year of experience in the di- 
etetic service of a health care institution. 

(c) Is a graduate of a dietetic technician or dietetic assistant training 
program approved by the American Dietetic Association. 

(d) Is a graduate of a state-approved program that provides 90 or more 
hours of classroom instruction in food service supervision. 

(e) Has training experience in food service supervision and manage- 
ment in a military service equivalent in content to (c) or (d) of the above. 

NOTE: Authority cited: Sections 131 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4—6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operafion of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.77. Dietitian. 

Dietitian means a person who is registered or eligible for registration 
as such by the American Dietetic Association. 

Note: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.79. Differential Diagnosis. 

Differential diagnosis means determining the type of dementia most 
probable or possible for an individual patient. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register87, No. 15). 



Page 1256 



(4-1-90) 



Title 22 



Health Planning and Facility Construction 



§ 97300.103 



§97300.81. Director. 

Director means the Director of the Office of Statewide Health Plan- 
ning and Development except in those Subchapters or Sections where 
otherwise defined. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.83. Disinfection. 

Disinfection means the process employed to destroy harmful microor- 
ganisms, but ordinarily not viruses and bacterial spores. 
NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon fiUng. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.85. Distinct Part. 

Distinct part means an identifiable unit accommodating beds or pa- 
tients, including but not limited to contiguous rooms, a wing, floor or 
building, that is approved by the Office for a specific purpose. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 13 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.87. Drug. 

(a) Drug means a medication. 

(b) Legend drug means any of the following: 

(1) Any drug labeled with the statement "Caution: Federal Law pro- 
hibits dispensing without prescription" or words of similar iinport. 

(2) Any dangerous drug under Section 421 1 of the Business and Pro- 
fessions Code. 

(c) Psychotropic drug means a medication used to modify behavior. 

NOTE: Authority cited: Sections 1311.5 and 13 12.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New secdon filed 4—6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.89. Drug Administration. 

Drug administration means the act in which a single dose of a pre- 
scribed drug or biological is given to a patient. The complete act of ad- 
ministration entails removing an individual dose from a container (in- 
cluding a unit dose container), verifying the dose with the prescriber's 
orders, giving the individual dose to the patient and promptly recording 
the time and dose given. 

NOTE: Authority cited: Sections 13 11.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.91 . Drug Dispensing. 

Drug dispensing means the act entailing the interpretation of a pre- 
scription order for a drug or biological and the proper selection, measur- 
ing, packaging, labeling and issuance of the drug or biological for a pa- 
tient. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 



History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.93. Evaluation. 

Evaluation means the measurement of the impact and effectiveness of 
the Alzheimer's Disease Institute demonstration project in providing ap- 
propriate and comprehensive services to patients with Alzheimer's dis- 
ease and related demendas and their families and/or caregivers through 
an integrated continuum of services. 

NOTE: Authority cited: Sections 1311.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.95. Fomites. 

Fomites means objects, or articles of clothing or material that are not 
in themselves contaminated but are able to harbor pathogenic microor- 
ganisms which may, by that means, be transmitted to others. 
NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
]. New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97300.97. Full-Time Equivalent. 

Full-time equivalent means a summing of hours worked by part-time 
staff and divided by the 40 hours of a normal work week. The result can 
be expressed as numbers of F.T.E. staff. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New secfion filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.99. Governing Body. 

Governing body means the person, persons, board of trustees, board 
of directors, or other body in whom the final authority and responsibility 
is vested for operation of the institute. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.1 03. Infectious Wastes. 

Infectious wastes means: 

(1) Significant laboratory wastes including pathological specimens 
which shall include all tissues, specimens of blood elements, excreta and 
secretions obtained from patients, and disposable articles or objects 
which may harbor or transmit pathogenic organisms. 

(2) Surgical specimens, including human parts or tissues removed sur- 
gically. 

(3) Equipment, instruments, utensils and articles or objects of a dispos- 
able nature, from the treatment, recovery and holding areas of patients 
with suspected or diagnosed communicable disease who, by nature of the 
disease, are required to be isolated by public health agencies. 

NOTE: Authority cited: Sections 131 1.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 



Page 1257 



(4-1-90) 



§ 97300.105 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



§97300.105. Inpatient. 

Inpatient means a patient of an Alzheimer's Disease Institute who is 
admitted to the Skilled Nursing Services Unit or Intermediate Care Ser- 
vices Unit or Residential Care Services Unit or Hospice Care Services 
Unit on a residential basis. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 13). 

§ 97300.1 07. Inspection Visit. 

Inpatient visit means the inspection conducted by Department staff, 
Office staff and/or staff of other State departments as appropriate to mon- 
itor compliance with the criteria and standards established by the Office 
pursuant to Sections 131 1.5 and 1312.7 of the Health and Safety Code 
and this Chapter. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 

1. New secfion filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§97300.109. Institute. 

Institute means a designated Alzheimer's Disease Institute. 
NOTE: Authonty cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 

1 . New secfion filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.1 1 1 . Intake Management. 

Intake management means the determination of whether a person can 
benefit from the Institute's programs and whether it is appropriate to ad- 
mit that person. 

NOTE: Authority cited: Secfions 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New secfion filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§97300.113. Integrated. 

Integrated means the close coordination of all types of services and 
care to the Insfitute padent. 

NOTE: Authority cited: Secfions 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New secfion filed 4-6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.1 1 5. Interdisciplinary Team. 

Interdisciplinary team means a group of persons including but not lim- 
ited to at least one representative from each of the following staff disci- 
plines: 

(a) Physician (Medical Director or designee); 

(b) Social worker; 

(c) Registered nurse; 

(d) Psychologist. 

NOTE: Authority cited: Secfions 1 31 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New secfion filed 4-6-87 as an emergency; effective upon fiUng. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 



fion 1312.7 and is repealed bv operation of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.1 1 7. Intermediate Care Bed Classification. 

Intermediate care bed classificaUon means beds designated for pa- 
tients requiring skilled nursing and supportive care on less than a continu- 
ous basis. 

NOTE: Authority cited: Sections 1 311 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.119. Licensed Nurse. 

Licensed nurse means a registered nurse or hcensed vocational nurse. 
NOTE; Authority cited: Secfions 131 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97300.1 21 . Licensed Vocational Nurse. 

Licensed Vocational Nurse means a person licensed as such by the 
California Board of Vocational Nurse and Psychiatric Technician Ex- 
aminers. 

NOTE: Authority cited; Secfions 131 1.5 and 13 12.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.123. Local Bank. 

Local bank means any bank or any branch office of a bank which is 
in the vicinity of the Institute. 

NOTE: Authority cited: Secfions 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operafion of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§97300.125. Maintenance. 

Maintenance means the upkeep of a building and equipment to pre- 
serve the original functional and operational state. 
NOTE: Authority cited: Sections 1311.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97300.1 27. Meaning of Words. 

Words shall have their usual meaning unless the context or a definition 
clearly indicates a different meaning. Words used in the present tense in- 
clude the future; words in the singular number include the plural number; 
words in the plural number include the singular number. Shall means 
mandatory. May means permissive. Should means suggested and recom- 
mended. 

NOTE: Authority cited: Secfions 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.1 29. Mechanically Altered Diet. 

Mechanically altered diet means a diet altered in texture. 



Page 1258 



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Title 22 



Health Planning and Facility Construction 



§ 97300.151 



NOTE: Authority cited: Sections 1311 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97300.131. Medication. 

Medication means any chemical compound, remedy or noninfectious 
biological substance, the action of which is not solely mechanical, which 
may be administered to patients by any route as an aid in the diagnosis, 
treatment, or prevention of disease or other abnormal condition, for relief 
of pain or suffering, or to control or improve any psychological or patho- 
logical condition. Products which contain medications but which are pri- 
marily used for cosmetic or other nonmedication purposes are not medi- 
cations as defined above. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.1 33. Music Therapist. 

Music therapist means a person who has a bachelor's degree in music 
therapy and who is registered or eligible for registration as such with the 
National Association for Music Therapy. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1 312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.135. Narrative Notes. 

Narrative notes means a written record which relates, reports or re- 
views facts about a patient and which includes but is not limited to obser- 
vations of patients, patients' reactions to care, and response to treatment. 
NOTE: Authority cited: Sections 13 1 1 .5 and 131 2.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.1 37. New Construction. 

New construction means any of the following: 

(a) New facilities. 

(b) Additions to existing buildings. 

(c) Conversions of existing building or portions thereof not currently 
licensed as a health facility. 

NOTE: Authority cited: Secfions 1 3 1 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.139. Nonambulatory Patient. 

Nonambulatory patient means a patient who is unable to leave a build- 
ing unassisted under emergency conditions. 

(1) The term nonambulatory patient includes, but is not limited to, pa- 
tients who depend upon mechanical aids such as crutches, walkers and 
wheelchairs. 

NOTE: Authority cited: Secfions 1311 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 



History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.1 41 . Nursing Unit. 

Nursing unit means a designated inpatient care area of an Institute 
which is planned, organized, operated and maintained to function as a 
unit. It includes patients' rooms with adequate support accommodations, 
services, and personnel providing nursing care and necessary manage- 
ment of patients. 

NOTE: Authority cited: Secfions 131 1.5 and 1312. 7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New secfion filed 4—6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.143. Occupational Therapist. 

Occupational therapist means a person who is a graduate of an occupa- 
tional therapy curriculum accredited jointly by the Council on Medical 
Education of the American Medical Association and the American Occu- 
pational Therapy Association, and who is registered or who is eligible for 
registration by the American Occupational Therapy Association. 
NOTE: Authority cited: Sections 131 1.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.145. Occupational Therapy Aide. 

Occupational therapy aide means a person who, under the supervision 
of a registered occupational therapist, assists with occupational therapy 
services. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.147. Occupational Therapy Assistant. 

Occupational therapy assistant means a person who is certified or eli- 
gible for certification as such by the American Occupational Therapy As- 
sociation. 

NOTE: Authority cited: Secfions 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New secfion filed 4—6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97300.149. Office. 

Office means the Office of Statewide Health Planning and Develop- 
ment. 

NOTE: Authority cited: Sections 1311.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4—6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1 312.7 and is repealed by operation of that same section effecfive 7-1-90 
(Register 87, No. 15). 

§97300.151. Patient. 

A patient means an individual admitted by an Alzheimer's Disease In- 
stitute to receive services. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 3 1 2 .7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New secfion filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 



Page 1259 



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§ 97300.153 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97300.153. Patient File. 

Patient file means the central file kept for eacii patient. 
NOTE; Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.155. Permanently Converted. 

Permanently converted means space which is not available for patient 
accommodation because the Institute has converted the patient accom- 
modation space to some other use and such space could not be recon- 
verted to patient accommodation within 24 hours. 

NOTE: Authority cited: Secdons 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97300.157. Pharmacist. 

Pharmacist means a person licensed as such by the California Board 
of Pharmacy. 

NOTE: Authority cited: Secdons 131 1.5 and 1312.7. Health and Safety Code. Ref- 
erence: Secdon 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This secdon 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
don 1312.7 and is repealed by operadon of that same section effecdve 7-1-90 
(Register 87, No. 15). 

§97300.159. Physical Therapist. 

Physical Therapist means a person licensed as such by the California 
Board of Medical Quality Assurance. 

NOTE: Authority cited: Sections 131i:5and 1312.7, Health and Safety Code. Ref- 
erence: Secdon 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecdve upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operadon of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.1 61 . Physical Therapist Aide. 

Physical therapist aide means a person who, under the direct supervi- 
sion of the registered physical therapist, assists with physical therapy 
care. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This secdon 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
don 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.163. Physical Therapist Assistant. 

Physical therapist assistant means a person who is approved as such 
by the Physical Tlierapy Examining Committee of the California Board 
of Medical Quality Assurance. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secdon 1312, Health and Safety Code. 

History 
1. New secdon filed 4-6-87 as an emergency; effective upon filing. This secdon 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
don 1312.7 and is repealed by operadon of that same secdon effective 7-1-90 
(Register 87, No. 15). 

§97300.165. Physician. 

Physician means a person licensed as a physician and surgeon by the 
California Board of Medical Quality Assurance or by the Board of Osteo- 
pathic Examiners. 



NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Secdon 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operadon of that same secdon effective 7-1-90 
(Register 87, No. 15). 

§ 97300.167. Physician's Assistant. 

Physician's assistant means a person who is certified as such by the 
Physician's Assistant Examining Committee of the California Board of 
Medical Quality Assurance. 

NOTE: Authority cited: Secdons 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New secdon filed 4-6-87 as an emergency; effective upon filing. This secdon 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
don 1312.7 and is repealed by operadon of that same secdon effective 7-1-90 
(Register 87, No. 15). 

§97300.169. Plan of Corrections. 

Plan of corrections means the report issued by Department staff listing 
the deficiencies found as a result of the inspection visit and the correc- 
tions necessary on the part of the Institute to be in compliance with this 
Chapter. 

NOTE: Authority cited: Secdons 131 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecdve upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
don 1312.7 and is repealed by operadon of that same section effecdve 7-1-90 
(Register 87, No. 15). 

§97300.171. Podiatrist. 

Podiatrist means a person licensed as such by the California Board of 
Medical Quality Assurance. 

Note: Authority cited: Secdons 131 1.5 and 13 12.7, Health and Safety Code. Ref- 
erence: Secdon 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effecdve upon filing. This secdon 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
don 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.173. Program Administrator. 

Program administrator means that person appointed in writing who is 
responsible for the operation of a type of services or types of services, and 
the patients at that type of services or types of services. 
NOTE: Authority cited: Secdons 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secdon 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secdon effective 7-1-90 
(Register 87, No. 15). 

§97300.175. Protocol. 

Protocol means a model for the provision of a single type of services 
or care. The protocol may consist of a series of instructions to be followed 
or a set of treatments to be accomplished in a specific order. 
NOTE: Authority cited: Secdons 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312,Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effecdve upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secdon effecdve 7-1-90 
(Register 87, No. 15). 

§97300.177. Provider. 

A provider is an entity with which the Institute has a contract or other 
written agreement to provide one of the following types of services on 
behalf of the Institute: 



Page 1260 



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Title 22 



Health Planning and Facility Construction 



§ 97300.197 



(a) Social Day Care Services. 

(b) Home Health Care Services. 

(c) In-Home Supportive Services. 

(d) Respite Care Services. 

(e) Hospice Care Services. 

(f) Referral Services. 

NOTE: Authority cited: Sections 1 31 1 .5 and 1 3 12.7, Health and Safety Code. Ref- 
erence: Section 1312. Health and Safety Code. 

History 
J . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97300.179. Psychiatrist. 

Psychiatrist means a person who is licensed as a physician and surgeon 
by the California Board of Medical Quality Assurance or the Board of 
Osteopathic Examiners and who meets any of the following: 

(a) Is certified or eligible for certification as a psychiatrist by the 
American Board of Psychiatry and Neurology, 

(b) Is certified or eligible for certification as a psychiatrist by the 
American Osteopathic Board of Neurology and Psychiatry, 

(c) Has specialized training and experience in psychiatry. 

NOTE: Authority cited: Sections 13 11. 5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
I. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1 312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.1 81 . Psychologist. 

(a) Psychologist means a person licensed as such by the California 
Board of Medical Quality Assurance. 

(b) Clinical psychologist means a psychologist licensed by the Board 
of Medical Quality Assurance who (1) possesses an earned doctorate de- 
gree in psychology from an educational institution meeting the criteria 
of Subdivision (b) of Section 29 14 of the Business and Professions Code 
and (2) has at least two years of clinical experience in a multidisciplinary 
facility licensed or operated by this or another state or by the United 
States to provide health care, or, is listed in the latest edition of the Na- 
tional Register of Health Services Providers in Psychology, as adopted 
by the Council for the National Register of Health Service Providers in 
Psychology. 

NOTE; Authority cited: Sections 131 1.5 and 131 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. (Section filed 4-6-87 as an emer- 
gency; effective upon filing. This section was adopted on an interim basis as autho- 
rized by Health and Safety Code Section 1312.7 and is repealed by operation of 
that same section effective 7-1-90 (Register 87, No. 15). 

§97300.183. Public Health Nurse. 

Public health nurse means a person licensed as a registered nurse who 
possesses a public health nursing certificate issued by the Department. 
NOTE; Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecUve upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.185. Qualified Applicant. 

A qualified applicant means an entity which has demonstrated in its 
proposal that it would be able to meet the standards and criteria for oper- 
ating an Alzheimer's Disease Institute. 

NOTE; Authority cited: SecUons 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1310.2, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effecfive 7-1-90 
(Register 87, No. 15). 



§97300.187. Recreation Therapist. 

Recreation therapist means a person with specialization in therapeutic 
recreation who is registered or eligible for registration as such by the Cal- 
ifornia Board of Park and Recreation Personnel or the National Thera- 
peutic Recreation Society. 

NOTE; Authority cited: Sections 1311 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section J 3 12, Health and Safety Code. 

History 
1. New secfion filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of thai same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.189. Registered Nurse. 

Registered nurse means a person licensed as such by the California 
Board of Registered Nursing. 

NOTE; Authority cited: Secfions 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 

1 . New secfion filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effecfive 7-1-90 
(Register 87, No. 15). 

§ 97300.191 . Registered Record Administrator. 

Registered record administrator means a person who is registered as 
such by the American Medical Record Association. 
NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
v/as adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97300.1 93. Registry Staff. 

Registry staff means Institute staff personnel provided b) a placement 
service on a temporary or on a day-to-day basis. 

NOTE; Authority cited: Secfions 131 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97300.195. Related Dementias. 

Related dementias means progressively deteriorating dementias, in- 
cluding but not limited to the following: 
(!) Vascular demenua. 

(2) Parkinson's and dementia. 

(3) Pseudodementia/depression. 

(4) Metabolic dementia. 

(5) Alcoholic dementia. 

(6) Amnestic syndrome. 

(7) Pick's disease. 

(8) Creutzfeld-Jakob disease. 

NOTE: Authority cited: Secfions 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New secfion filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97300.197. Research. 

(a) Basic research means the study of the epidemiology, etiology and 
pathogenesis of Alzheimer's disease and related dementias. 

(b) Clinical research means the study of clinical care and treatment and 
systems of care utilizing observations of patient behavior and/or other 
measurements of outcome. 

(c) Applied research means the study of the delivery of, costs of and 
impact of services to patients with Alzheimer's disease and related de- 
mentias and their families and/or caregivers. 



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Title 22 



NOTE; Authority cited: Sections 1 3 1 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 , New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97300.199. Restraint. 

Restraint means controlling a patient's physical activity in order to 
protect the patient or others from injury. 

NOTE: Authority cited: Sections 1 3 11 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.203. Services Unit. 

Services unit is that distinct part or area or areas of the Institute in 
which a type of services, as defined in Section 97300.229, is provided 
and/or administered. 

NOTE: Authority cited: Sections 13 II. 5 and 13 12.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.205. Services Unit Patient Health Record. 

Services unit patient health record or patient's Unit health record 
means a record that organizes all services information on the care and 
treatment rendered to a patient in a unit. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97300.207. Skilled Nursing Care Bed Classification. 

Skilled nursing care bed classification means beds designated for pa- 
tients requiring skilled nursing care on a continuous and extended basis. 
NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effecdve 7-1-90 
(Register 87, No. 15). 

§ 97300.209. Social Work Aide. 

Social work aide means a staff person who receives orientation, on- 
the-job training and supervision from a social worker or a social work 
assistant. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.21 1 . Social Work Assistant. 

Social work assistant means a person with a baccalaureate degree in 
the social sciences or related fields who receives supervision, consulta- 
tion and in-service training from a social worker. 

NOTE: Authority cited: Secfions 1311.5 and 131 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effecdve upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 



tion 1312.7 and is repealed bv operation of that same section effective 7-1-90 
(Register87, No. 15). 

§97300.213. Social Worker. 

Social worker means a person who: 

(1) Has a inaster's degree in social work and is a graduate of a school 
of social work accredited or approved by the Council on Social Work 
Education, and who has one year of experience in the provision of ser- 
vices to the aged in any setting and who has special training in gerontolo- 
gy or, 

(2) Is licensed as a clinical social worker by the Board of Behavioral 
Science Examiners. 

NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Heahh and Safety Code. Ref 

erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.215. Speech Pathologist. 

Speech pathologist means a person licensed as such by the California 
Board of Medical Quality Assurance or a person who has a master's de- 
gree in the field and is authorized to practice under the supervision of a 
licensed speech pathologist as outlined in section 2530.5(f) of Chapter 
5.3 of the Business and Professions Code. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same section effecdve 7-1-90 
(Register 87, No. 15). 

§ 97300.21 7. Speech Therapist. 

Speech therapist means a person hcensed as such by the California 
Board of Medical Quality Assurance. 

NOTE: Authority cited: Secfions 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
don 1312.7 and is repealed by operadon of that same section effective 7-1-90 
(Register 87, No. 15). 

§97300.219. Standing Orders. 

Standing orders means those written orders which are used or intended 
to be used in the absence of a prescriber's specific order for a specific pa- 
tient. 

NOTE: Authority cited: Secfions 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
I. New section filed 4-6-87 as an emergency; effecdve upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operadon of that same secdon effecdve 7-1-90 
(Register 87, No. 15). 

§97300.221. Sterilization. 

Sterilization means the process employed to destroy all living organ- 
isms. 

NOTE: Authority cited: Secfions 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This secdon 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.223. Supervision. 

(a) Supervision means to instruct an employee or subordinate in their 
duties and to oversee or direct work, but does not necessarily require the 
immediate presence of the supervisor. 

(b) Direct supervision means that the supervisor shall be present in the 
same building as the person being supervised, and available for consulta- 
tion and assistance. 



Page 1262 



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Health Planning and Facility Construction 



§ 97320.7 



• 



(c) Immediate supervision means tiiat the supervisor shall be physical- 
ly present while a task is being performed by the person being supervised. 
NOTE: Authority cited: Sections 1311.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.225. Therapeutic Diet. 

Therapeutic diet means any diet modified from a regular diet in a man- 
ner essential to the treatment or control of a particular disease, illness or 
condition. 

NOTE: Authority cited: Sections 131 1 .5 and 1 31 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

HtSTORY 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.227. Treatment and Management Plan. 

Treatment and management plan means that plan established for each 
Institute patient by an interdisciplinary team. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97300.229. Type of Services. 

A type of services means one of the following: 

(a) Skilled Nursing Care Services. 

(b) Intermediate Care Services. 

(c) Outpatient Care Services. 

(d) Day Health Care Services. 

(e) Social Day Care Services. 

(f) Home Health Care Services. 

(g) In-Home Supportive Services, 
(h) Respite Care Services. 

(i) Hospice Care Services, 
(j) Residential Care Services, 
(k) Referral Services. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New section file 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97300.231 . Unit Dose Medication System. 

Unit does medication system means a system in which single dosage 
units of drugs are prepackaged and prelabeled in accordance with all 
applicable laws and regulations governing these practices and are made 
available separated as to patient and by dosage time. The system shall 
also comprise, but not be limited to, all equipment and appropriate re- 
cords deemed necessary to make the dose available to the patient in an 
accurate and safe manner. A pharmacist shall be in charge of and respon- 
sible for the system. 

NOTE; Authority cited: Secfions 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 

1. New secfion filed 4-6-87 as an emergency; effecfive upon fihng. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operafion of that same secfion effective 7-1-90 
(Register 87, No. 15). 



Subchapter 2. General Requirements 



Article 1. Institute Administration 

§97320.1. Administrator. 

(a) Each Institute must have a full time administrator who may be a li- 
censed nursing home administrator. If the administrator is not a licensed 
nursing home administrator, the administrator shall: 

(1) Have aMaster's Degree in business administration or a health field 
and, 

(2) Have two years experience in administration of a health facility. 

(b) If the administrator is to be absent for more than 30 consecutive 
days, the administrator shall appoint an acting administrator to carry out 
the day-to-day functions of the Institute. 

NOTE: Authority cited: Secfions 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1311.5, Health and Safety Code. 

History 

1. New secfion filed 4-6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97320.3. Designee— General Duties. 

(a) The designee shall be responsible for compliance with designation 
requirements for the organization, management, operation and control of 
the Institute. The delegation of any authority by a designee shall not di- 
minish the responsibilities of such designee. 

(b) The designee, if qualified as an administrator, may act as the ad- 
ministrator or shall appoint an administrator to carry out the policies of 
the designee. 

(c) The designee shall delegate to the designated administrator, in 
writing, authority to organize and carry out the day-to-day functions of 
the Institute. 

NOTE; Authority cited: Secfions 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97320.5. Designation. 

(a) The designation by the Office of an Institute is not transferable, un- 
less approved by the Office and shall remain in effect, unless the Office 
removes such designation for cause, until July 1, 1990, which is the re- 
peal date of the Duffy Alzheimer's Disease Institute Act, or, if the Legis- 
lature deletes or extends that date, until such date as the act is repealed. 

(b) No person, firm, partnership, association, corporation, joint ven- 
ture, political subdivision of the state or other governmental agency shall 
establish, operate or maintain a designated Alzheimer's Disease Insti- 
tute, or indicate, represent, or advertise by any means that it operates a 
designated Alzheimer's Disease Institute, without first obtaining a desig- 
nation as an Alzheimer's Disease Institute from the Office. 

(c) A licensed health care facility which provides Alzheimer's disease 
services and which is not designated under this article, shall not be pre- 
cluded from holding out, advertising, or conducting those services or 
programs. 

NOTE: Authority cited: Secfions 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, 1312.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97320.7. Advertising. 

No Institute shall make or disseminate false or misleading statements 
or advertise by any other manner or means any false or misleading claims 
regarding facilities or services provided. 



Page 1263 



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Title 22 



NOTE: Authority cited: Sections ] 3 1 J .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



§ 97320.9. Data. 

Each Institute shall provide the Office statistical data and patient infor- 
mation deemed necessary by the Office in accordance with procedures 
developed by the Office to ensure confidentiality of patient information. 

NOTE: Authority cited: Sections 1311.5 and 13 12.7, Health and Safety Code. Ref- 
erence: Section 1311.2, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97320.1 1 . Equipment and Supplies. 

(a) Equipment and supplies in each Institute shall be of the quality and 
in the quantity necessary for care of patients as ordered or indicated. At 
least the following items shall be provided and properly maintained at all 
times: 

(1) Airways. 

(2) Bedpans. 

(3) Catheter equipment. 

(4) Clerical supplies and equipment. 

(5) Current drug reference which lists, for each drug administered in 
the Institute, indications for use, dosage range and side effects. 

(6) Denture cups. 

(7) Drug service trays and/or carts. 

(8) Ear syringes. 

(9) Emergency oxygen supply and equipment for administration. 

(10) Emesis basins. 

(11) Examination light. 

(12) First aid supplies, as determined by the Patient Care Policy Com- 
mittee. 

(13) Flashlights. 

(14) Gloves (sterile and unsterile). 

(15) Icecaps. 

(16) Intravenous therapy supplies if Institute provides such services. 

(17) Medicine droppers. 

(18) Medicine glasses, cups or other small containers which are accu- 
rately calibrated. 

(19) Mortar and pestle. 

(20) Rectal speculum. 

(21) Refrigerator with accurate thermometer. 

(22) Rubber tubing. 

(23) Scales for weighing all patients. 

(24) Shower and commode chairs, wheelchairs and walkers. 

(25) Soap for bathing. 

(26) Soap dishes or soap containers. 

(27) Sphygmomanometers. 

(28) Sterile dressings. 

(29) Stethoscopes. 

(30) Suction apparatus. 

(31) Suture tray. 

(32) Suture removal equipment. 

(33) Syringes and needles. 

(34) Test supplies necessary to perform urine sugar and acetone test- 
ing. 

(35) Thermometers, oral and rectal. 

(36) Tongue depressors. 

(37) Urinals. 

(38) Vaginal speculum. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. 



History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97320.13. Consumer Information to Be Posted. 

(a) The following consumer information shall be conspicuously 
posted in a prominent location accessible to the public. 

(1) A copy of the Designation Certificate. 

(2) Name and date of employment of the current administrator of the 
Institute. 

(3) A listing of all types of services and special programs provided in 
the Institute and those provided through contracts or other written agree- 
ments. The listing will show the authorized number of patients for each 
type of services. 

(4) The current and following week's menus for regular and therapeu- 
tic diets. 

(5) A notice that the Institute's written admission and discharge poli- 
cies are available upon request. 

(6) The most recent inspection visit report as well as the related 
follow-up plan of corrections. 

(7) The name and address of the designee, who may be a person, firm, 
partnership, association, joint venture, corporation or parent or subsid- 
iary corporation. 

(8) A listing of all skilled nursing and intermediate care facilities 
owned by the same person, firm, partnership, association, joint venture, 
corporation or parent or subsidiary corporation. 

(9) A statement that an action to withdraw or suspend in whole or in 
part the designation of the Institute is pending, if such an action has been 
initiated by the Office, pursuant to Section 1 3 11 .2 of the Health and Safe- 
ty Code, and the accusation has been served on the designee. 

(10) A notice of the name, address and telephone number of the appro- 
priate District Office of the Licensing and Certification Division, Depart- 
ment of Health Services. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97320.15. Required Committees. 

(a) Each InstitiJte shall have at least the following committees: Patient 
Care PoHcy, Infection Control and Pharmaceutical Service. 

(b) Minutes of every committee meeting shall be maintained in the In- 
stitute and indicate names of members present, date, length of meeting, 
subject matter discussed and action taken. 

(c) Committee composition and function shall be as follows: 
(1) Patient Care Policy Committee. 

(A) The Committee shall be composed of: at least one physician, the 
Institute administrator, the Director of Nursing Services, a pharmacist, 
the activity leader and representatives of each type of services as appro- 
priate. 

(B) The Committee shall meet at least quarterly. Minutes shall list po- 
licies established or reviewed and decisions reached. 

(C) A Patient Care Policy Committee shall establish policies govern- 
ing the following services: Physician, dental, nursing, dietetic, pharma- 
ceutical, health records, housekeeping, activity programs and such addi- 
tional services as are provided or arranged for by the Institute. The 
Committee shall review these services at least semi-annually. 

(D) The Patient Care Policy Committee shall have the responsibility 
for reviewing and approving all pohcies relating to patient care. The 
Committee shall review patient care policies semi-annually and revise 
as necessary. The Committee shall also review all contracts for the provi- 
sion of care to patients by a non-Institute provider. Based on reports re- 
ceived from the Institute administrator, the Committee shall review the 



Page 1264 



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§ 97320.19 



effectiveness of policy implementation and shall make recommenda- 
tions for the improvement of patient care. 

(2) Infection Control Committee. 

(A) An Infection Control Committee shall be responsible for infection 
control policy in the Institute. 

(B) The Committee shall be composed of representatives from the fol- 
lowing services; physician, nursing, administration, dietetic, pharma- 
ceutical, activities, housekeeping, laundry and maintenance and others 
as appropriate. 

(C) The Committee shall meet at least quarterly. 

(D) The functions of the Infection Control Committee shall include, 
but not be limited to: 

1. Establishing, reviewing, monitoring and approving policies and 
procedures for investigating, controlling and preventing infections in the 
Institute. 

2. Maintaining, reviewing and reporting statistics of the number, 
types, sources and locations of infections within the Institute. 

(3) Pharmaceutical Service Committee. 

(A) A Pharmaceutical Service Committee shall direct the pharmaceu- 
tical services in the Institute. 

(B) The Committee shall be composed of the following: a pharmacist, 
the Director of Nursing Services, the Institute administrator and at least 
one physician. 

(C) The Committee shall meet at least quarterly. 

(D) The functions of the Pharmaceutical Service Committee shall in- 
clude, but not be limited to: 

1. Establishing, reviewing, monitoring and approving pohcies and 
procedures for safe procurement, storage, distribution and use of drugs 
and biologicals. 

2. Reviewing and taking appropriate action on the pharmacist's quar- 
terly report. 

3. Recommending measures for improvement of services and the se- 
lection of pharmaceutical reference materials. 

NOTE; Authority cited: Sections 1311.5 and 13 12.7, Health and Safety Code. Ref- 
erence: Section 1311 .5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97320.17. Patient Care Policies and Procedures. 

(a) Written patient care policies and procedures shall be established 
and implemented to ensure that patient related Institute goals and objec- 
tives are achieved. 

(b) All patient care policies and procedures required by these regula- 
tions shall be in writing, made available upon request to physicians and 
other involved health professionals, patients or their representatives, em- 
ployees and the public and shall be carried out as written. Policies and 
procedures shall be reviewed at least semi-annually, revised as needed 
and approved in writing by the Patient Care Policy Committee. 

(c) Each Institute shall establish and implement policies and proce- 
dures, including but not limited to: 

(1) Physician services policies and procedures which include: 

(A) Orientation of new physicians to the Institute and changes in phy- 
sician services and/or policies. 

(B) Schedule of patient evaluation visits by the attending physician 
and documentation of alternate schedules for such visits. 

(2) Nursing services policies and procedures which include: 

(A) A current nursing procedure manual. 

(B) Provision for the inventory and identification of patients' personal 
possessions, equipment and valuables. 

(C) Procedures for screening of all patients for tuberculosis upon ad- 
mission to inpatient service. These procedures shall be determined by the 
Patient Care Policy Committee. 

(D) Notification of patient's physician regarding sudden or marked 
adverse change in patient's condition. 



(E) Conditions under which restraints are used, the application of re- 
straints, and the mechanism used for monitoring and controlling their 
use. 

(3) Infection control policies and procedures. 

(4) Dietary services policies and procedures which include: 

(A) Provision for safe, nutritious food preparation and service. 

(B) A provision for maintaining a current dietetic service procedure 
manual. 

(5) Pharmaceutical services policies and procedures. 

(6) Activity program policies and procedures. 

(7) Housekeeping services policies and procedures which include pro- 
vision for maintenance of a safe, clean environment for patients, em- 
ployees and the public. 

(8) Costs of care. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Heakh and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

HtSTORY 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that sajne section effective 7-1-90 
(Register 87, No. 15). 

§ 97320.19. Administrative Policies and Procedures. 

(a) Written administrative, management and personnel policies shall 
be established and implemented to govern the administration and man- 
agement of the Institute. 

(b) All administrative, management, and personnel policies and proce- 
dures required by these regulations shall be in writing and shall be carried 
out as written. They shall be made available upon request to patients or 
their agents and to employees and the public. Policies and procedures 
shall be reviewed at least annually, revised as needed and approved in 
writing by the governing body or designee. 

(c) Each Institute shall establish at least the following: 

(1) Personnel policies and procedures which shall include: 

(A) Written job descriptions detailing qualifications, duties and limita- 
tions of each classification of employee which shall be made available 
to all personnel. 

(B) Provisions for employee orientation to the Institute, nature of Alz- 
heimer's disease and related dementias, job, patient population, policies, 
procedures and staff. 

(C) Provisions for staff development. 

(D) Description of employee benefits. 

(E) Description of employee health and grooming standards. 

(F) Provisions for verification of licensure, credentials and references. 

(2) Policies and procedures for patient admission, leave of absence, 
transfer, discharge, categories of patients accepted and retained, services 
included in the basic rate, types of services offered, charges for extra ser- 
vices, limitations of services, cause for termination of services and re- 
fund policies applying to termination of services. 

(3) Policies and procedures for admission or discharge of a patient 
which state that a patient shall not be admitted or discharged on the basis 
of race, color, religion, sex, ancestry or national origin. 

(4) Written policies and procedures governing patient's health records 
which shall be developed with the assistance of a person skilled in record 
maintenance and preservation. 

(A) Policies and procedures governing access to, duplication of and 
dissemination of, information from the patient's health records. 

(B) Policies and procedures to ensure the confidentiality of patient 
health information, in accordance with applicable laws and regulations. 

(5) Policies and procedures to assure that the Institute accepts and re- 
tains only those patients for whom it can provide care. 

(6) Procedures for reporting of unusual occurrences. 

(d) The Institute shall maintain a current organizational chart showing 
the types of services of the Institute, the person in charge of each type of 
services, the lines of authority, responsibility, communication, and the 
staff assignments. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 



Page 1265 



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§ 97320.21 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



§ 97320.21 . Arranged for Services. 

(a) When an Institute arranges for any type of services to be provided 
to patients or their families and/or caregivers, by any other provider of 
services, the arrangement shall be by contract or other written agreement. 

(b) Any such contract or other written agreement for the provision of 
a type of services shall be approved in writing by the Office before the 
services are provided. 

(c) If any such contract or other written agreement is for the provision 
of a type of services licensed by the State, the contract or written agree- 
ment must be with a licensed provider. 

(d) Copies of affiliation agreements, contracts, or other written agree- 
ments for advice, consultation, services, training or transportation, with 
other facilities, organizations or individuals, or public or private agen- 
cies, shall be on file in the Institute's administrative office. These shall 
be readily available for inspection and review by the Office and the De- 
partment. 

(e) Any contract or other written agreement for the provision of a type 
of services shall: 

(1) Include the following general provisions: 

(A) A description of the type of services to be provided. 

(B) Financial arrangements. 

(C) Conditions upon which the agreement or contract can be termi- 
nated. 

(D) Time frame of the agreement or contract. 

(E) Effective date of agreement or contract. 

(F) Date agreement or contract was signed. 

(2) Detail any special requirements that are imposed on the provider 
because of its affiliation with the Alzheimer's Disease Institute, includ- 
ing but not limited to the following: 

(A) Record keeping. 

(B) Data to be provided to the Institute, Office and Department. 

(C) Program access to be provided to the Institute, Office and Depart- 
ment. 

(D) Special programs or services related to Alzheimer's disease and 
related demetias. 

(E) Responding to the special needs of patients with Alzheimer's dis- 
ease and related dementias and their families and caregivers. 

(3) For any non-licensed provider, require that the services be pro- 
vided in accordance with the applicable Subchapter of this Chapter, and 
address each of the following: 

(A) Staffing. 

(B) Protection of patients' health and safety. 

(C) Protection of patients' property. 

(D) Physical plant requirements. 

(E) Any other areas as appropriate or determined to be necessary by 
the Department or Office. 

NOTE: Authority cited: Sections 1 31 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97320.23. Bonds. 

(a) Each Instimte shall file or have on file with the Department a bond 
issued by a surety company authorized to do business in California if the 
Institute is handling or will handle money in the amount of $25 or more 
per patient or $500 or more for all patients in any month. The amount of 
the bond shall be according to the following schedule: 

(1) Total Amount Handled 



Bond Required 

$750 or less $1,000 

$751 to $1,500 $2,000 

$1,501 to $2,500 $3,000 

(2) Every further increment of $1,000 or fraction thereof shall require 

an additional $1,000 on the bond. 

(b) Each application for designation shall be accompanied by an affi- 
davit on a form provided by the Department. Tlie affidavit shall state 
whether the Institute handles or will handle money of patients and the 
maximum amount of money to be handled for: 

(1) Any patient. 

(2) All patients in any month. 

(c) No Institute shall either handle money of a patient or handle 
amounts greater than those slated in the affidavit submitted by the Insti- 
tute without first notifying the Department and fihng a new or revised 
bond if requested. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
don 1312.7 and is repealed by operation of that same section effecfive 7-1-90 
(Register87, No. 15). 

§ 97320.25. Reports and Monitoring. 

(a) The Institute shall maintain records of program activities in each 
services unit, data on patients served, and financial expenditures. Before 
the Institute begins operations the Office will advise the Institute of the 
minimum record keeping and data collection requirements. 

(b) Monthly reports covering the previous month's activities will be 
submitted to the Office containing required information and data. 

(c) Institute records shall be open for review by the duly authorized 
representatives of the Office or the Department. Such representatives of 
the Office or the Department shall be allowed to monitor, assess, or eval- 
uate the Institute's program operations and investigate complaints. These 
reviews may include audits, onsite observations and interviews of project 
staff and patients or their families. The Institute shall provide assurance 
to the Office and the Department that records and/or patient information 
will be available for inspection and will permit duly authorized represen- 
tatives from either the Office or the Department access to the physical fa- 
cilities of the Institute for such purposes. 

(d) The Institute shall assure that any provider under contract or other 
written agreement to provide care to Institute patients, shall keep records 
of care to Institute patients. Such Institute patient records shall also be 
available for inspection by the duly authorized staff of the Office and De- 
partment and access to the physical facilities and Institute patient records 
of the providers and/or contractors shall be assured by the Institute. 
NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 131 1.2, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97320.27. Agreement with School of iVIedicine. 

(a) Each Institute shall, before commencing the admission of patients, 
have entered into an interagency agreement with a school of medicine 
under which the Institute will provide physical space and access to pa- 
tients as needed for such programs. 

(b) Programs shall include: 

(1) Clinical research; 

(2) Preclinical, clinical, and postgraduate training of health science 
students; 

(3) Professional education of physicians, registered nurses, and other 
health care providers and health professionals; 

(4) Education of the public, patients' famihes, and other caregivers; 
and 

(c) The agreement will specify what additional services will be neces- 
sary to establish continuity of care for patients. 



Page 1266 



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Title 22 



Health Planning and Facility Construction 



§ 97321.5 



(d) The agreement will specify that all education and training pro- 
grams shall emphasize the utilization of an interdisciplinary team ap- 
proach 10 the care, treatment, and/or supervision of patients with Alz- 
heimer's disease or related dementias. 

(e) The agreement shall describe in detail the responsibilities of the In- 
stitute to provide sufficient space, equipment, and clerical staff for each 
program of research, training, and education. 

(f) The agreement shall include the provisions for the obtaining of in- 
formed consent from patients or their representative prior to being used 
as subjects in any research, training, or education program. 

(g) The agreement shall describe the size of each such program in the 
Institute, the availability of Institute patients, the nature of any charges, 
costs, reimbursements or billings, and whether the medical school facul- 
ty, residents or instructors shall receive separate remuneration for their 
participation in Institute programs described in this section. 

Note. Authority cited: Sections 13 11. 5 and 131 2.7, Health and Safety Code. Ref- 
erence: Section 13] 1.7, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97320.29. Research and Evaluation. 

(a) The Institute shall have a research and evaluation program to ap- 
propriately implement the purposes of Section 1310.3 of the Health and 
Safety Code. The research and evaluation program shall be directed to- 
ward, but not limited to, the following issues on Alzheimer's disease and 
other related dementias: 

(1) Epidemiology. 

(2) Etiology and pathogeneses. 

(3) Diagnosis. 

(4) Clinical care. 

(5) Treatment. 

(6) Care of the family and/or caregiver. 

(7) System of care. 

(b) The research and evaluation program shall provide opportunities 
for basic and clinical research and shall encourage researchers and re- 
search institutions to participate in the Institute's research program. 

(c) The research and evaluation program shall take appropriate steps 
to protect patients' rights and confidentiality. 

(d) The Institute shall assist and cooperate in the Office's evaluation 
of the Institute's programs. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 13 12.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97320.31 . Family Services. 

(a) Family services that shall be provided by the Institute shall include 
but not be limited to: 

(1) Assessment of the needs of the family including a home visit, as 
appropriate; 

(2) Assistance with coordinated planning for the patient's care 
throughout the patient's illness; 

(3) Structured support groups; 

(4) Provision of referrals to appropriate community services, informa- 
tion about possible need to seek legal or financial advice on behalf of the 
patient, and education to encourage appropriate use of services; 

(5) Information about possible genetic components of Alzheimer's 
disease and related dementias; 

(6) Education to enable the family to assist the patient in the home set- 
ting as appropriate; 

(7) Counseling services related to stress management and coping with 
the patient's illness, planning for the patient's death, decisions regarding 



use of extraordinary life support means and autopsy arrangements and 
counseling during the terminal stages of illness; 

(8) Family therapy; 

(9) Bereavement counseling. 

NOTE: Authority cited: Sections 1311.5 and V312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



Article 2. Patient Services Management 

§ 97321 .1 . Services Provided. 

(a) Each Institute shall directly provide the following types of services: 
skilled nursing care, intermediate care, day health care, outpatient care 
and residential care! Institutes shall also provide or arrange for home 
health care, in-home supportive services, respite care, social day care, 
and hospice care. Referral services shall also be provided. 

(b) Specialty services to be provided on at least a consultative or con- 
tractual basis are the following: internal medicine, neurology, neurosur- 
gery, psychiatry (preferably geriatric psychiatry). 

(c) Case management services shall be provided to all patients so as 
to assure a coordinated continuum of care based on a plan submitted to 
and approved by the Office. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 1 5). 

§ 97321 .3. Admission of Patients. 

(a) The Institute shall admit only persons with Alzheimer's disease or 
related dementias unless the designation certificate provides for services 
to other pei'sons. 

(b) The Institute shall admit only persons over the age of 21. 

(c) The Institute shall admit a patient only on orders of an Institute phy- 
sician. 

(d) The Institute shall admit and retain only those patients for whom 
it can provide adequate care. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .5. intake Management. 

Before being admitted to an Institute a person shall be screened 
through an intake management process in the following steps: 

(a) IniUal contact with the patient or family, by a member of the inter- 
disciplinary team, shall determine if the applicant for admission shall be 
interviewed by the interdisciplinary team. If not, the applicant for admis- 
sion shall be referred to other programs. 

(b) The interdisciplinary team shall interview and determine whether 
the Institute has a program suitable for that applicant for admission. If not 
the applicant for admission shall be referred to other programs. 

(c) If the interdisciplinary team determines that the applicant for ad- 
mission would benefit from a program of the Institute, the interdisciplin- 
ary team may recommend to the physician team member that the appli- 
cant for admission be admitted. The physician shall have the final 
decision for admission. If the applicant is not admitted, the applicant shall 
be referred to other programs. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 



Page 1267 



(4-1-90) 



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BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as autliorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



§97321.7. Admissions. 

(a) At the time the patient is admitted the admitting physician shall de- 
tennine what type of services the patient needs and shall immediately or- 
der the appropriate type of services on a temporary basis. 

(b) The admitting physician shall iinmediately order a diagnostic eval- 
uation which shall be completed within five (5) business days. 

NOTE: Authority cited: Sections 1311. 5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 



§ 97321 .1 1 . Clinical Diagnosis of Alzheimer's Disease. 

(A) The criteria for the clinical diagnosis of PROBABLE Alzheimer's 
disease include: 

(1) Dementia established by clinical examination and documented by 
the Mini-Mental Test, Blessed Dementia Scale, or some similar exami- 
nation, and confirmed by neuropsychological tests; 

(2) Deficits in two or more areas of cognition; 

(3) Progressive worsening of memory and other cognitive functions; 

(4) No disturbance of consciousness; 

(5) Onset between ages 40 and 90, most often after age 65; and 

(6) Absence of systemic disorders or other brain diseases that in and 
of themselves could account for the progressive deficits in memory and 
cognition. 

(B) The diagnosis of PROBABLE Alzheimer's disease is supported 
by: 

(1) Progressive deterioration of specific cognitive functions such as 
language (aphasia), motor skills (apraxia), and perception (agnosia); 

(2) Impaired activities of daily living and altered patterns of behavior; 

(3) Family history of similar disorders, particularly if confirmed neu- 
ropathologically; and 

(4) Laboratory results of: 

(a) Normal lumbar puncture as evaluated by standard techniques, 

(b) Normal pattern or nonspecific changes in EEG, such as increased 
slow-wave activity, and 

(c) Evidence of cerebral atrophy on CT with progression documented 
by serial observation. 

(C) Other clinical features consistent with the diagnosis of PROB- 
ABLE Alzheimer's disease, after exclusion of causes of dementia other 
than Alzheimer's disease, include: 

(1) Plateaus in the course of progression of the illness; 

(2) Associated symptoms of depression, insomnia, incontinence, delu- 
sions, illusions, hallucinations, catastrophic verbal, emotional, or physi- 
cal outburst, sexual disorders, and weight loss; 

(3) Other neurologic abnormalities in some patients, especially with 
more advanced disease and including motor signs such as increased 
muscle tone, myoclonus, or gait disorder; 

(4) Seizures in advanced disease; and 

(5) CT normal for age. 

(D) Features that make the diagnosis of PROBABLE Alzheimer's dis- 
ease uncertain or unlikely include: 

(1) Sudden, apoplectic onset; 

(2) Focal neurologic findings such as hemiparesis, sensory loss, visual 
field deficits, and incoordination early in the course of the illness; and 

(3) Seizures or gait disturbances at the onset or very early in the course 
of the illness. 

(E) Clinical diagnosis of POSSIBLE Alzheimer's disease: 



(1 ) May be made on the basis of the dementia syndrome, in the absence 
of other neurologic, psychiatric, or systemic disorders sufficient to cause 
dementia, and in the presence of variations in the onset, in the presenta- 
tion, or in the chnical course; 

(2) May be made in the presence of a second systemic or brain disorder 
sufficient to produce dementia, which is not considered to be the cause 
of the dementia; and 

(3) Should be used in research studies when a single, gradually pro- 
gressive severe cognitive deficit is identified in the absence of other iden- 
tifiable cause. 

(F) Criteria for diagnosis of DEFINITE Alzheimer's disease are: 

(1) The clinical criteria for PROBABLE Alzheimer's disease. 

(2) Histopathologic evidence obtained from a biopsy or autopsy. 

(G) Classification of Alzheimer's disease for research purposes 
should specify features that may differentiate subtypes of the disorder, 
such as: 

(1) Famihal occurrence. 

(2) Onset before age of 65. 

(3) Presence of trisomy-21 ; and 

(4) Coexistence of other relevant conditions such as Parkinson's dis- 
ease. 

NOTE; Authority cited: Sections 131 1.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effecfive 7-1-90 
(Register 87, No. 15). 

§ 97321 .13. Comprehensive Assessment. 

(a) If, after the diagnostic evaluation, it is determined that the patient 
does not have Alzheimer's disease or a related dementia, the patient will 
be discharged and referred to a non-Institute program. 

(b) If, after the diagnostic evaluation, it is determined that the patient 
has a diagnosis of Alzheimer's disease (possible or probable) or a related 
dementia, the patient will be given a complete comprehensive asses- 
sment for the development of a treatment and management plan by the 
interdisciplinary team. In addition, the interdisciplinary team may re- 
quire evaluation reports from the medical specialties of internal medi- 
cine, neurology, neurosurgery and psychiatry (preferably geriatric psy- 
chiatry) as appropriate. The patient at that time will be assigned to a case 
manager by the Medical Director. 

NOTE: Authority cited: Secfions 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effecfive upon fifing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97321 .15. Treatment and Management Plan. 

(a) A treatment and management plan shall be developed for each pa- 
tient by the interdisciplinary team after the diagnostic evaluation and 
comprehensive assessment. 

(1) The patient's family physician or referring physician may be in- 
vited to participate in the development of the treatment and management 
plan. 

(2) The treatment and management plan shall be signed by the physi- 
cian member of the interdisciphnary team within five (5) business days 
after the diagnostic evaluation is complete. 

(b) The treatment and management plan will contain, but not be lim- 
ited to, the following medical information, treatment protocols and rec- 
ommendations: 

(1) Diagnosis. 

(2) Types of services and care prescribed for the patient, family and/or 
caregiver. 

(3) Physical health status and prescribed medications. 

(4) Psychosocial health status. 



Page 1268 



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Health Planning and Facility Construction 



§ 97321.23 



• 



(5) Written and signed orders for diet and diagnostic tests. 

(6) Management of behavioral problems. 

(c) Based upon the treatment and management plan, appropriate ser- 
vices and placement shall be ordered for the patient, family. and/or care- 
giver. 

(d) The following subjects shall be considered for discussion with the 
patient and family and/or caregiver. Appropriate notations may be made 
in the treatment and management plan. 

(1) Family understanding of the Institute's programs. 

(2) Family participation with the interdisciplinary team in the develop- 
ment of a treatment and management plan and in the discussion of the ex- 
tent to which extraordinary life support systems will be used in the termi- 
nal stages of Alzheimer's disease or related dementias. 

(3) Research programs. 

(4) A plan for continuing involvement of the family in the patient's 
care. 

(5) Family understanding that a diagnosis of Alzheimer's disease can- 
not be confirmed without an autopsy. 

(6) The need for family services as outlined in Section 97320.31. 

(7) Financial needs. 

(8) Possible need to seek legal advice and review legal issues relevant 
to a patient with dementia. 

(9) Home and living arrangements. 

(10) Program options available from the Institute and/or other commu- 
nity resources. 

(11) Genetic counseling. 

(e) Each treatment and management plan shall be reviewed and up- 
dated by the case manager after consultation with the interdisciplinary 
tarn and with staff of the unit or units from which the patient receives ser- 
vices, as frequently as the patient's condition warrants and at least every 
60 days. 

NOTE: Authority cited: Sections 13 11. 5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 7. Needs of Patients. 

In determining the needs of the patient, the Institute shall, wherever 
available, obtain and utilize the following information relating to the pa- 
tient: 

(1) Diagnosis and recommendation of type of services from the pa- 
tient's private physician. 

(2) Comments from any social worker, registered nurse or other health 
professional acquainted with the social, emotional and physical or medi- 
cal needs of the patient. 

(3) Any social service or special rehabilitative needs. 

(4) Need for special nursing care. 

(5) Social history and living habits obtained from the patient or family. 

(6) Preference for location of placement, including the family ' s prefer- 
ence. 

(7) Financial resources and limitations. 

(8) Religious, cultural, dietary and activity preferences. 

NOTE: Authority cited: Sections 13 11. 5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
] . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .19. Admission Records. 

(a) For each patient the Institute shall complete an admission record 
which shall include the following: 

(1) Name and Social Security number. 

(2) Current address. 

(3) Age and date of birth. 



(4) Sex. 

(5) Date of admission. 

(6) Name, address and telephone number of guardian, authorized rep- 
resentative, person or agency responsible for patient. 

(7) Name, address and telephone number of next of kin. 

(8) Name, address and telephone number of attending physician. 

(9) Name, address and telephone number of the designated alternate 
physician. 

(10) Admission diagnoses, known allergies and complete health 
history. 

(11) Medicare and Medi-Cal numbers when appropriate. 

(b) For each inpatient the admission record shall include in addition 
to items specified in subsection (a) above, an inventory including but not 
limited to: 

(1) Items of jewelry. 

(2) Items of furniture. 

(3) Radios, television and other appliances. 

(4) Prosthetic and orthopedic devices. 

(5) Other valuable items, so identified by the patient's family or autho- 
rized representative. 

NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .21 . Patient Identification. 

(a) Each inpatient shall be provided with a wristband identification tag 
or other means of identification which shall be worn at all times unless 
the attending physician notes in the health record that the patient's condi- 
tion would not permit such identification. Minimum information shall in- 
clude the name of the patient and the name, address and telephone num- 
ber of the Institute. 

(b) All other patients shall be provided with a name identification 
badge which shall be worn at all times while receiving services except at 
home or when otherwise inappropriate. Minimum identification shall in- 
clude the name of the patient and the name, address and telephone num- 
ber of the Institute. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1311.5, Health and Safety Code. 

History 
1. New secfion filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effecfive 7-1-90 
(Register 87, No. 15). 

§ 97321 .23. Patients' Health Records. 

(a) Records shall be permanent, either typewritten or legibly written 
in ink, be capable of being photocopied and shall be kept on all patients. 
All health records of discharged patients shall be completed and filed 
within 30 days after discharge date and such records shall be kept for a 
minimum of 7 years. All exposed X-ray film shall be retained for seven 
years. All required records, either originals or accurate reproductions 
thereof, shall be maintained in such form as to be legible and readily 
available upon the request of the attending physician, the Institute staff 
or any authorized officer, agent, or employee of either, duly authorized 
representatives of the Office or Department or any other person autho- 
rized by law to make such request. 

(b) Information contained in the health records shall be confidential 
and shall be disclosed only to authorized persons in accordance with fed- 
eral, state and local laws. 

(c) If an Institute ceases operation, the Office and the Department shall 
be informed within three business days by the designee of the arrange- 
ments made for the safe preservation of the patients' health records. 

(d) The Department shall be informed within three business days, in 
writing, whenever patients' health records are defaced or destroyed be- 
fore termination of the required retention period. 



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BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



(e) Patients' health records shall be current and kept in detail consis- 
tent with good medical and professional practice based on the service 
provided to each patient. Such records shall be filed and maintained in 
accordance with these requirements and shall be available for review by 
the Department. All entries in the health record shall be authenticate with 
the date, name, and title of the persons making the entry. 

(t) All current clinical information pertaining to a patient's stay shall 
be centralized in the patient's health record. 

(g) The patient's health record will be part of the central patient file. 

(h) Patients' health records shall be filed in an accessible manner in the 
Institute or in health record storage. Storage of records shall provide for 
prompt retrieval when needed for continuity of care. Health records can 
be stored off the Institute premises only with the prior approval of the De- 
partment. 

(i) The patient's health record shall not be removed from the Institute, 
except for storage after the patient is discharged, unless expressly and 
specifically authorized by the Department. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .25. Content of Health Records. 

(a) The Institute shall maintain for each patient a health record which 
shall include: 

(1) Admission record. 

(2) Current report of physical examination, and evidence of tuberculo- 
sis screening. 

(3) Current diagnoses. 

(4) Physician orders, including drugs, treatment and diet orders, prog- 
ress notes, signed and dated on each visit. Physician's orders shall be cor- 
rectly recapitulated. 

(5) Nurses' notes which shall be signed and dated. Nurses' notes shall 
include: 

(A) Records made by nurse assistants, after proper instruction, which 
shall include: 

1 . Care and treatment of the patient. 

2. Narrative notes of observation of how the patient looks, feels, eats, 
drinks, reacts, interacts and the degree of dependency and motivation to- 
ward improved health. 

3. Notification to the licensed nurse of changes in the patient's condi- 
tion. 

(B) Meaningful and informative nurses' progress notes written by li- 
censed nurses as often as the patient's condition warrants. However, 
weekly nurses' progress notes shall be written by licensed nurses on each 
skilled nursing care and intermediate care patient and shall be specific to 
the patient's needs, the patient's nursing care plan and the padent's re- 
sponse to care and treatments. 

(C) Name, dosage and time of administration of drugs, the route of ad- 
ministration or site of injection, if other than oral. If the scheduled time 
is indicated on the record, the initials of the person administering the dose 
shall be recorded, provided that the drug is given within one hour of the 
scheduled time. If the scheduled time is not recorded, the person adminis- 
tering the dose shall record both initials and the time of administration. 
Medication and treatment records shall contain the name and profession- 
al title of staff signing by initials. 

(D) Justification for and the results of the administration of all PRN 
medications and the withholding of scheduled medications. 

(E) Record of type of restraint and time of application and removal. 
The time of application and removal shall not be required for postural 
supports used for the support and protection of the patient. 

(F) Medications and treatments administered and recorded as pre- 
scribed. 

(G) Documentation of oxygen administration. 



(6) Temperature, pulse, respiration and blood pressure notations when 
indicated. 

(7) Laboratory reports of all tests prescribed and completed. 

(8) Reports of all X-rays prescribed and completed. 

(9) Progress notes written and dated by the case manager at least quar- 
terly. 

(10) Discharge planning notes when applicable. 

(1 1 ) If a patient receives meals at the Institute, observadon and infor- 
mation pertinent to the patient's diet recorded in the patient's Unit health 
record by the dietitian, nurse or food service supervisor. 

(12) If the patient is receiving therapy, records of each treatment given 
by the therapist, weekly progress notes and a record of reports to the phy- 
sician after the first 2 weeks of therapy and at least every 30 days thereaf- 
ter. 

( 1 3) Progress notes written by the social service worker if the patient 
is receiving social services. 

(14) Other progress notes by any other health professional treating the 
patient. 

(15) Consent forms for prescribed treatment and medication not in- 
cluded in the admission consent for care. 

(1 6) Condition and diagnoses of the patient at time of discharge or final 
disposition. 

(17) A copy of the transfer form when the patient is transferred to 
another health facility. 

(18) An inventory of each inpatient's personal effects and valuables 
as defined in Section 97321 . 1 9 made upon admission and discharge. The 
inventory list shall be signed by a representadve of the Institute and the 
patient or their authorized representative with one copy to be retained by 
each. 

(19) If a patient is transferred from the Institute the name, complete 
and address and telephone number of the new facility or program. 
NOTE: Authority cited: Sections 1 31 1 .5 and 1 31 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .27. Patients' Care Plan. 

(a) Each service unit of the Institute shall develop and maintain a pa- 
dent care plan for each patient which will detail the day-to-day needs of 
the patient, be developed by unit staff in accord with the treatment and 
management plan (a copy of which shall be kept with each inpatient care 
plan) and be reviewed when the treatment and management plan is re- 
viewed and revised as necessary. 

(b) The care plan will contain the services unit health record which will 
contain all progress notes made by unit staff and other health profession- 
als providing any treatment or care to the patient. 

(c) Copies of the padent's care plan shall be maintained in the central 
patient file. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .29. Patients' Rights. 

(a) Written policies regarding the rights of patients shall be estabUshed 
and shall be available to the patient, to any conservator, next of kin or 
sponsoring agency and to the public. Such policies and procedures shall 
ensure that each patient admitted to the Institute shall have the following 
rights and be notified of the Institute's obligations: 

(1) To be fully informed, as evidenced by the padent's written ac- 
knowledgement prior to or at the time of admission and during stay, of 
these rights and of all rules and regulations governing patient conduct. 



Page 1270 



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§ 97321.31 



(2) To be fully informed, prior to or at the time of admission and during 
stay, of services available in the Institute and of related charges, includ- 
ing any charges for services not covered by the Institute's basic per diem 
rates or not covered under Titles XVIII or XIX of the Social Security Act. 

(3) To be fully informed by a physician of his or her medical condition, 
unJess medically contraindicated, and to be afforded the opportunity to 
participate in the planning of medical treatment or other health care, and 
to refuse to participate in experimental research. 

(4) To refuse treatment, care, supervision or any other service to the 
extent permitted by law, and to be informed of the medical consequences 
of such refusal. 

(5) To be transferred or discharged only for medical reasons, or for the 
patient's welfare or that of other patients or for nonpayment for his or her 
stay, or if the interdisciplinary team determines that the patient should be 
transferred and to be given reasonable advance notice to ensure orderly 
transfer or discharge. Such actions shall be documented in the patient's 
health record. 

(6) To be encouraged and assisted throughout the period of stay to ex- 
ercise rights as a patient and as a citizen, and to this end, to voice griev- 
ances and recommended changes in policies and services to Institute staff 
and/or outside representatives of the patient's choice, free from restraint, 
interference, coercion, discrimination or reprisal. 

(7) To manage personal financial affairs, or to be given at least a quar- 
terly accounting of financial transactions made on the patient's behalf 
should the Institute accept written delegation of this responsibility sub- 
ject to the provisions of Section 97321.31. 

(8) To be free from mental and physical abuse and to be free from 
chemical and (except in emergencies) physical restraints except as autho- 
rized in writing by a physician or other person lawfully authorized to pre- 
scribe care for a specified and limited period of time, or when necessary 
to protect the patient from injury to the patient or to others. 

(9) To be assured confidential treatment of personal and medical re- 
cords and to approve or refuse their release to any individual outside the 
Institute except in the case of transfer to another health facility, or as re- 
quired by law or this Chapter, or by a third party payment contract. 

(10) To be treated with consideration, respect and full recognition of 
dignity and individuality, including privacy in treatment and in care of 
personal needs. 

(1 1) Not to be required to perform services for the Institute that are not 
included for therapeutic purposes in the patient's plan of care. 

(12) To associate and communicate privately with persons of the pa- 
tient's choice, and to send and receive personal mail unopened, unless 
medically contraindicated. 

(13) To meet with others and participate in activities of social, reli- 
gious and community groups, unless medically contraindicated. 

(14) To retain and use personal clothing and possessions as space per- 
mits, unless to do so would infringe upon rights of other patients or unless 
medically contraindicated. 

(15) If married, to be assured privacy for visits by the patient's spouse 
and if both the patients are inpatients, and assigned to the same services 
unit, to be permitted to share a room, unless medically contraindicated. 

(16) To have daily visiting hours established. 

(17) To have visits from members of the clergy at any time at the re- 
quest of the patient or the patient's conservator. 

(18) To allow relatives, or persons responsible, to visit critically ill pa- 
tients at any time, unless medically contraindicated. 

(19) To be allowed privacy for visits with family, friends, clergy, so- 
cial workers or for professional or business purposes. 

(20) To have reasonable access to telephones and to make and receive 
confidential calls. 

(b) A patient's rights, as set forth above, may be denied or limited only 
for good cause which shall be evidenced by the written order of the at- 
tending physician, and may only be denied or limited if such denial or 
limitation is otherwise authorized by law. Reasons for denial or limita- 



tion of such rights shall be documented by the attending physician in the 
patient's Unit health record. 

(c) All rights specified in Section 97321.29(a)(1) through (4) as they 
pertain to a patient adjudicated incompetent in accordance with state law 
or to a patient who is found by the attending physician to be medically 
incapable of understanding these rights shall devolve to such patient's 
conservator, next of kin, or sponsoring agency. 

NOTE: Authority cited: Sections 1311.5 and 1 31 2.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .31 . Safeguards for Patients' Monies and 
Valuables. 

(a) Each Institute to which a patient's money or valuables have been 
entrusted shall comply with the following: 

(1) No designee shall mingle patients' monies or valuables with that 
of the designee or the Institute. Patients' monies and valuables shall be 
maintained separately, intact and free from any liability that the designee 
incurs in the use of the designee's or the Institute's funds. The provisions 
of this section shall not be interpreted to preclude prosecution for the 
fraudulent appropriation of patients' monies or valuables as theft, as de- 
fined by Section 484 of the Penal Code. 

(2) Each designee shall maintain safeguards and accurate records of 
patients' monies and valuables entrusted to the designee's care, for each 
patient, including the maintenance of a detailed inventory and at least a 
quarterly accounting of financial transactions made on the patient's be- 
half. 

(A) Records of patients' monies which are maintained as a drawing ac- 
count shall include a control account for all receipts and expenditures, 
supporting vouchers and receipts for all expenditures of monies and valu- 
ables entrusted to the designee, an account for each patient and support- 
ing vouchers filed in chronological order. Each account shall be kept cur- 
rent with columns for debits, credits and balance. All of these records 
shall be maintained at the Institute for a minimum of three years from the 
date of transaction. At no time may the balance in a patient's drawing ac- 
count be less than zero. 

(B) Records of patients' monies and other valuables entrusted to the 
designee for safekeeping shall include a copy of the receipt furnished to 
the patient or to the patient's authorized representative. Each item of pa- 
tient property entrusted to the designee shall be clearly identified as be- 
longing to that patient. 

(3) Patients' monies not kept in the Institute shall be deposited in a de- 
mand trust account in a local bank authorized to do business in California, 
the deposits of which are insured by the Federal Deposit Insurance Cor- 
poration, or in a federally insured bank or savings and loan association 
under a plan approved by the Department. All banking records related to 
these funds, including but not limited to deposit slips, checks, canceled 
checks, statements and check registers, shall be maintained in the Insti- 
tute for a minimum of three years from the date of transaction. Identifica- 
tion as a patient trust fund account shall be clearly printed on each pa- 
tient's trust account checks and bank statements. 

(4) A separate list shall be maintained for all checks from patient funds 
which are, or have been, outstanding for 45 days or more as reflected on 
the most recent bank statement. Bank statements shall be reconciled 
monthly with copies of the reconciliation maintained by the Institute. 
Any checks on such accounts which have been written off or uncashed 
shall result in an addition to the appropriate patient's account. 

(5) Expenditures, for a particular patient, from the patient fund account 
as specified in (3) above may not exceed the drawing right that the patient 
has in the account. Expenditures from the patient fund account shall only 
be for the immediate benefit of that psirticular patient. No more than one 



Page 1271 



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BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



month's advanced payment for care may be received from a patient's ac- 
count. 

(6) Any person, firm, partnership, joint venture, association or corpo- 
ration which is licensed to operate health facihties in addition to the Insti- 
tute shall maintain a separate demand trust account as specified in (3) 
above for each such facility. Records relating to these accounts shall be 
maintained at each facility as specified in (2) above. Patient funds from 
the Institute shall not be mingled with funds irom another facility. 

(7) When the amount of patients' money entrusted to a designee ex- 
ceeds $500, all money n excess of $500 shall be deposited in a demand 
trust account as specified in (3) and (5) above unless the designee pro- 
vides a fireproof safe and the designee desires the protection accorded by 
Section 1860 of the Civil Code. 

(8) Upon discharge of a patient, all money and valuables of that patient 
which have been entaisted to the designee and kept within the Institute 
shall be surrendered to the patient or authorized representative in ex- 
change for a signed receipt. Monies in a demand trust account or with the 
county treasurer shall be made available within three normal banking 
days. Upon discharge, the patient or authorized representative shall be 
given a detailed list of personal property and a current copy of the debits 
and credits of the patient's monies. 

(9) Within 30 days following the death of a patient, except in a coroner 
or medical examiner case, all money and valuables of that patient which 
have been entrusted to the designee shall be surrendered to the person re- 
sponsible for the patient or to the executor or the administrator of the es- 
tate in exchange for a signed receipt. Whenever a patient without known 
heirs dies, written notice, within five working days, shall be given by the 
Institute to the pubhc administrator of the county as specified by Section 
1145 of the California Probate Code and a copy of said notice shall be 
available in the Institute for review by the Department. 

(10) Upon change of ownership of an Insdtute, there shall be a written 
verification by a public accountant of all patients' monies which are be- 
ing transferred to the custody of the new owner(s). A signed receipt for 
the amount of funds in the patients' trust account shall be given by the 
new owner to the previous owner. 

(11) Upon closure of an Institute a written verification by a public ac- 
countant of all patients' monies shall be available for review by the De- 
partment. Each pafient's monies shall be transferred with the patient. 

(b) If property is purchased for use of more than one patient, from pa- 
tient trust funds, the Institute shall secure a written agreement between 
all patients whose funds are used, or their authorized representatives. The 
agreement shall expressly acknowledge consent of all parties and shall 
provide for disposition of the property in the event of disagreements, dis- 
charge, transfer or death. 

(c) No designee, owner, administrator, employee, or any immediate 
relative or representative of the aforementioned may act as an authorized 
representative of parents' monies or valuables, unless the patient is a rel- 
ative within the second degree of consanguinity. 

(d) The Institute shall make reasonable efforts to safeguard patients' 
property and valuables that are in possession of the patient. 

(e) For purposes of this secdon, patients' funds maintained in a finan- 
cial institution shall be deemed to be entrusted to an Institute if the desig- 
nee, or any agent or employee thereof, is an authorized signatory to said 
account. Records maintained and provided by the financial instimtion in 
accordance with a plan which has been approved in writing by the De- 
partment, may fulfill the obligation of the Insdtute with regard to the 
maintenance of records for such funds. 

Note; Authority cited: Sections 13 11 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
] . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



§ 97321 .33. Patient Transfer. 

(a) The Insdtute shall maintain written transfer agreements with other 
nearby health facilides as appropriate to make the services of those facih- 
des accessible and to facilitate the transfer of padents. Complete and ac- 
curate patient information, in sufficient detail to provide for condnuity 
of care, shall be transferred with the patient at dme of transfer. 

(b) When a patient is transferred to another facility, the following shall 
be entered in the padent health record: 

(1 ) The date, dme, condidon of the padent and a written statement of 
the reason for the transfer. 

(2) Informed written or telephone acknowledgement by the padent, 
patient's guardian or authorized representadve except in an emergency 
or as provided in Section 97321.29(a)(5). 

NOTE: Authority cited: Sections 1 311 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .35. Bed or Services Unit Space Hold. 

(a) If a padent of an Institute is transferred to a general acute care hos- 
pital as defined in Section 1 250(a) of the Health and Safety Code, the In- 
sdtute shall afford the padent a bed or services unit space hold of seven 
(7) days which may be exercised by the padent or the padent' s represen- 
tadve. 

(1) Upon transfer to a general acute care hospital, the patient or the pa- 
tient's representadve shall notify the Insdtute within twenty-four (24) 
hours after being informed of the right to have the bed or services unit 
space held, if the padent desires the bed or services unit space held. 

(2) Any patient who exercises the bed or services unit space hold op- 
don shall be liable to pay reasonable charges, not to exceed the padent' s 
daily rate for care in the Insdtute, for bed or services unit space hold days. 

(3) If the patient's attending physician nodfies the Insdtute in wridng 
that the padent' s stay in the general acute care hospital is expected to ex- 
ceed seven (7) days, the Institute shall not be required to maintain the bed 
or services unit space hold. 

(b) Upon admission of the patient to the Institute and upon transfer of 
the padent of an Institute to a general acute care hospital, the Insdtute 
shall inform the padent, or the patient's representadve, in wridng of the 
right to exercise this bed or services unit space hold provision. Each no- 
dce shall include information that a padent will be liable for the cost of 
the bed or services unit space hold days, and that insurcince may or may 
not cover such costs. 

(c) An Insdtute who fails to meet these requirements shall offer to the 
patient the next available bed or services unit space appropriate for the 
patient's needs. This requirement shall be in addidon to any other reme- 
dies provided by law. 

NOTE: Authority cited: Sections 13 11.5 and 13 12. 7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safely Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register87, No. 15). 

§ 97321 .37. Liability for Rent and Return of Rental 
Advance. 

(a) Whenever accommodations in an Institute are rented by or for a pa- 
dent on a month to month basis, the renter or his heir, legatee or personal 
representative shall not be liable for any rent due under the rental agree- 
ment for accommodations beyond the date on which the patient died. 

(b) Any advance of rent by the renter shall be returned to the heir, lega- 
tee or personal representadve of the padent no later than two weeks after 
discharge or death of the padent. 



Page 1272 



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Health Planning and Facility Construction 



§ 97321.43 



(c) The rights described in (a) and (b) above shall not be modified or 
waived in the rental agreement. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 
i . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .39. Patient Death Reports. 

(a) All patients' deaths shall be reported by the designee to the Depart- 
ment. The report shall be made accurately at a time and in such a manner 
as may be requested by the Department or its designee. 
NOTE: Authority cited: Sections 13 11. 5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5. Health and Safety Code. 

History 

] . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1 312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .41 . Central Patient File. 

(a) The Institute shall maintain one central file for each patient which 
shall contain all records, data, plans and any other information relating 
to the patient. Copies of any records of treatment or nursing care plans 
or care plans, maintained in conjunction with the provision of any type 
of services shall be transferred to the central file at reasonable intervals 
of time. 

(b) The patient file shall include but not be limited to: 

(1) Treatment and management plan. 

(2) Health records, including admission records. 

(3) Nursing care plan. 

(4) Evaluation of the patient and review of orders for care and treat- 
ment when there is a change in the patient's attending physician. 

(5) Activity plan. 

(6) Copies of patient's care plan including services unit health record. 

(7) Other plans as necessary. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4—6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .43. Dietetic Service— Food Service. 

(a) The dietetic service shall provide food to all inpatients of the quali- 
ty and quantity necessary to meet each inpatient's needs in accordance 
with the physicians' orders and to meet the "Recommended Dietary Al- 
lowances," the most current edition, which is the 1980 revision, adopted 
by the Food and Nutrition Board of the National Research Council of the 
National Academy of Sciences, 2107 Constitution Avenue, Washington, 
D.C. 20418 and meet the following standards for all inpatients of the In- 
stitute: 

(1) Not less than 3 meals shall be served daily. 

(2) Not more than 14-hours shall elapse between the evening meal and 
breakfast of the following day. 

(3) Nourishments or between-meal feeding shall be provided as re- 
quired by the diet prescription. Bedtime nourishments shall be offered to 
all patients unless contraindicated. 

(4) Patient food preferences shall be adhered to as much as possible 
and substitutes for all food refused shall be from appropriate food groups. 
Condiments such as salt, pepper or sugar shall be available at each meal 
unless contraindicated by the diet order. 

(5) Table service shall be provided for all patients who can and wish 
to eat at a table. Tables of appropriate height shall be provided for patients 
in wheelchairs. 

(6) No food ordered for the Institute shall be diverted or taken from the 
Institute. No rebates shall be received or allowed to the Institute or its 



owners, directors, officers or employees from any commercial food 
source. 

(7) When food is provided by an outside commercial food service, the 
Institute shall ensure that all federal, state and local requirements are met. 
The Institute shall maintain a written plan, adequate space, equipment 
and food supplies to provide food service to patients in emergencies. 

(8) Recipes for all items that are prepared for regular and therapeutic 
diets shall be available and used to prepare attractive and palatable meals, 
in which nutritive values, flavor and appearance are conserved. Food 
shall be served attractively, at appropriate temperatures with appropriate 
eating utensil and in a form to meet individual needs. 

(b) When meals are served in the Day Health Care Services Unit, So- 
cial Day Care Services Unit, the Outpatient Care Services Unit, or in any 
other Institute program in which patients are not residents of the Institute, 
such meals shall meet the following: 

( 1 ) All food shall be selected, stored, prepared and served in a safe and 
healthful manner. 

(2) Each patient who is in the Institute for four hours or more shall be 
served a meal that will supply at least one-third of the National Research 
Councils Recommended Dietary Allowances. 

(3) Each patient who is in the Institute for eight hours shall be served 
a meal and between-meal nourishments that will supply at least one-half 
of the National Research Council's Recommended Dietary Allowances. 

(4) Each patient receiving care for periods longer than eight hours shall 
be served at least two meals and between meal nourishments. 

(5) Any patient accepted at 7:00 a.m. or earlier shall be served a nour- 
ishing breakfast unless it has been determined that the patient has re- 
ceived a meal prior to arrival. 

(6) Therapeutic diets shall be provided for each patient whose diet has 
been prescribed by the patient's physician as a medical necessity. 

(7) The diet order for each patient shall be reviewed every 90 days by 
a dietitian and approved by the interdisciplinary team when reassessment 
is done. 

(8) When food is provided by an outside commercial food service, the 
apphcable requirements shall be met. Equipment and employees to re- 
ceive and serve the food and for cleanup shall be provided. Equipment 
for in-house preparation and service of food in emergencies shall be 
maintained. 

(9) When prepared food and beverages are obtained from a food man- 
agement service, the food management service shall be approved in ac- 
cordance with federal, state and local requirements. The Institute shall 
obtain from the food management service evidence of such approval. 
The food management service shall supply evidence to the Institute that 
menus are planned by a qualified dietitian. 

(10) When low-sodium and low-cholesterol diets are provided 
through Older Americans Act nutrition sites, the Unit's staff shall meet 
with the nutrition site dietitian to adjust menus to provide for special di- 
etary requirements of patients. 

(c) A current profile card shall be maintained for each patient, indicat- 
ing diet order, likes, dislikes., allergies to foods, diagnosis and instruc- 
tions or guidelines to be followed in the preparation and serving of food 
for the patient. 

(d) All regular and therapeutic diets shall be prescribed by a person 
lawfully authorized to give such an order. Verbal orders may be received 
and recorded by a qualified dietitian and shall be signed by the prescriber 
within five days. 

(e) Foods shall be prepared by methods that conserve nutritive value, 
flavor and appearance and shall be served at appropriate temperatures. 

(0 A dining area equipped for serving at meal time shall be provided. 

(g) Dishes, beverage containers and eating utensils appropriate for use 
with the food being served shall be provided. 

(h) Each patient shall be seated for meals on an individual chair, at a 
table, or as appropriate if the patient is in a wheelchair. 

(i) Each patient shall be assisted by employees during meals as needed. 



Page 1273 



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BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



(i) Special equipment and utensiJs shall be provided for self-help in 
eating as needed. 

(k) Sufficient food shall be prepared to provide additional servings as 
requested by the patient served, unless the patient is on a restricted diet 
prescribed by a physician. 

(J ) When necessary, food shall be cut, chopped or ground to meet the 

needs of the individual patients. 

NOTE: Amhority cited. Sections 1 31 1 .5 and 1 31 2.7, Health and Safely Code. Ref- 
erence: Section 1312. Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 13). 

§ 97321 .45. Dietetic Service — Diet Manual. 

A current therapeutic diet manual, approved by the dietitian and the 
Patient Care Policy Committee, shall be readily available to the attending 
physician, nursing and dietetic personnel. It shall be reviewed annually 
and revised at least every five years. 

NOTE: Authority cited: Sections 13 11. 5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon fihng. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .47. Dietetic Service — Policies and Procedures. 

Manuals of dietetic service policies and of procedures to implement 
the policies shall be available to all personnel concerned with dietetic ser- 
vices. Manuals shall be developed and kept current with the assistance 
of the dietitian in cooperation with appropriate staff from other services 
when overlapping functions occur. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secdon 1312, Health and Safety Code. 

History 
1. New secfion filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .49. Dietetic Service — Therapeutic Diets. 

Therapeutic diets shall be provided for each patient as prescribed and 
shall be planned, prepared and served with supervision and/or consulta- 
tion from the dietitian. Persons responsible for therapeutic diets shall 
have sufficient knowledge of food values to make appropriate substitu- 
tions when necessary. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .51 . Dietetic Service — Menus. 

(a) Menus for regular, modified and/or therapeutic diets shall be writ- 
ten at least one week in advance, dated and posted in the kitchen at least 
one week in advance. 

(b) All menus shall be approved by the dietitian. 

(c) If any meal served varies from the planned menu, the change and 
the reason for the change shall be noted in writing on the posted menu in 
the kitchen. 

(d) Menus shall provide a variety of foods and indicate standard por- 
tions at each meal. Menus shall be varied for the same day of consecutive 
weeks. If a cycle menu is used, the cycle shall be of no less than three 
weeks duration and shall be revised quarterly. 

(e) Menus shall be adjusted to include seasonal commodities. 

(0 Menus shall be planned with consideration of cultural and religious 
background, and food habits of patients. 



(g) A copy of the menu as served shall be kept on file for at least 30 
days. 

(h) Between-meal nourishments shall consists of but not be limited to 
a beverage and either fruits, vegetables or a grain product such as crack- 
ers, cookies or bread. 

(i) Menus shall be available for review by each patient or the patient's 
designated representative. 

(j) Itemized records of food purchases shall be kept for one year and 
available for review by the Department. Food purchases invoices are ac- 
ceptable provided they list amounts and types of foods purchases. 
NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 3 12.7. Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97321 .53. Dietetic Service— Food Storage. 

(a) Food storage areas shall be clean at all times. 

(b) All foods or food items not requiring refrigeration shall be stored 
at least 30 centimeters ( 1 2 inches) above the floor, on shelves, racks, dol- 
hes or other surfaces which facilitate thorough cleaning, in a ventilated 
room, not subject to sewage or wastewater backflow or contamination by 
condensation, leakage, rodents or vermin. All packaged food, canned 
foods, or food items stored shall be kept clean and dry at all times. 

(c) All readily perishable foods or beverages capable of supporting 
rapid and progressive growth of microorganisms which can cause food 
infections or food intoxication shall be maintained at temperatures of 7°C 
(45'^F) or below, or at 60"C (i40°F) or above, at all times, except during 
necessary periods of preparation and service. Frozen foods shall be 
stored at minus 18*^C (0°F) or below at all times. There shall be an accu- 
rate thermometer in each refrigerator and freezer and in storerooms used 
for perishable foods. All foods stored in walk-in refrigerators and freez- 
ers shall be stored above the floor on shelves, racks, dollies or other sur- 
faces that facilitate thorough cleaning. 

(d) Pesticides and other toxic substances and drugs shall not be stored 
in the kitchen area or in storerooms for food and/or food preparation 
equipment and utensils. 

(e) Soaps, detergents, cleaning compounds or similar substances shall 

be stored in separate defined storage areas. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency: effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effecfive 7-1-90 
(Register 87, No. 15). 

§ 97321 .55. Dietetic Service— Sanitation. 

(a) All kitchens and kitchen areas shall be kept clean, free from litter 
and rubbish and protected from rodents, roaches, flies and other insects. 

(b) All utensils, counters, shelves and equipment shall be kept clean, 
maintained in good repair and shall be free from breaks, corrosions, open 
seams, cracks and chipped areas. 

(c) Plastic ware, china and glassware that are unsightly, cannot be sani- 
tized or are hazardous because of chips, cracks or loss of glaze shall be 
discarded. 

(d) Ice which is used in connection with food or drink shall be from a 
sanitary source and shall be handled and dispensed in a sanitary manner. 

(e) Kitchen wastes hat are not disposed of by mechanical means shall 
be kept in clean, leakproof, nonabsorbent, tightly closed containers and 
shall be disposed of as frequently as necessary to prevent a nuisance or 
unsightliness. 

NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 



Page 1274 



(4-1-90) 



Title 22 



Health Planning and Facility Construction 



§ 97321.63 



• 



tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321.57. Dietetic Service — Cleaning and Disinfection of 
Utensils. 

(a) AH utensils used for eating, drinking and in the preparation and 
serving of food and drink shall be cleaned and disinfected or discarded 
after each usage. 

(b) Gross food particles shall be removed by careful scraping and pre- 
rinsing in running water. 

(c) The utensils shall be thorougliiy washed in hot water with a mini- 
mum temperature of 43°C (1 10"F), using soap or detergent, rinsed in hot 
water to remove soap or detergent and disinfected by one of the following 
methods or equivalent, as approved by the Department. 

(J ) Immersion for at least two minutes in clean water at 77°C (170°F). 

(2) Immersion for at least 30 seconds in clean water at 83°C (1 80°F). 

(3) Immersion in water containing bactericidal chemical as approved 
by the Department. 

(d) After disinfection the utensils shall be allowed to drain and dry in 
racks or baskets on nonabsorbent surfaces. Drying cloths shall not be 
used. 

(e) Results obtained with dishwashing machines shall be equal to those 
obtained by the methods outlined above and all dishwashing machines 
shall meet the requirements contained in Standard No. 3, for commercial 
spray-type dishwashing machines, as revised in June 1982, of the Na- 
tional Sanitation Foundation, P.O. Box 1468, Ann Arbor, MI 48106. Hot 
water at a minimum temperature of 83°C (180°F), shall be maintained at 
the manifold of the final rinse. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .59. Dietetic Service — Equipment and Supplies. 

(a) Equipment of the type and in the amount necessary for the proper 
preparation, serving and storing of food and for proper dishwashing shall 
be provided and maintained in good working order. 

(b) Fixed and mobile equipment in the dietetic service area shall be lo- 
cated to assure sanitary and safe operation and shall be of sufficient size 
to handle the needs of the facility. 

(c) The dietetic service area shall be ventilated in a manner that will 
maintain comfortable working conditions, remove objectionable odors 
and fumes and prevent excessive condensation. 

(d) Food supplies shall meet the following standards: 

(1) At least one week's supply of staple foods and at least two days' 
supply of perishable foods shall be maintained on the premises. Food 
supplies shall meet the requirements of the weekly menu including the 
therapeutic diets ordered. 

(2) All food shall be of good quality and procured from sources ap- 
proved or considered satisfactory by federal, state or local authorities. 
Food in unlabeled, rusty, leaking, broken containers or cans with side 
seam dents, rim dents or swells shall not be retained or used. Home 
canned food shall not be used. 

(3) Milk when served as a beverage, shall be pasteurized Grade A or 
certified unless otherwise prescribed by the physician's diet order. Milk, 
milk products and products resembling milk shall be processed or man- 
ufactured in milk product plants meeting the requirements of Division 15 
of the CaUfomia Food and Agricultural Code. Powdered milk shall not 
be used as a beverage but may be used in cooking. 

(4) Milk shall be served in individual containers or from a dispensing 
device which has been approved for such use by the local health depart- 
ment or from the original container. When milk is served in individual 
containers the cap or seal shall not be removed except in the presence of 
the patient. Milk shall be dispensed directly into the glass or other con- 
tainer from which the patient drinks. 



(5) Catered foods and beverages from a source outside the Institute 
shall be prepared, packed, property identified, stored and transported in 
compUance with these regulations and other applicable federal, state and 
local codes. 

(6) Foods held in refrigerated or other storage areas shall be covered. 
Liquids and food which are prepared and not served shall be tightly cov- 
ered, stored appropriately, clearly labeled and dated. A written procedure 
shall be estabUshed and followed for the safe use of leftover foods. 

(7) Spoiled or contaminated food shall not be served. 

(8) Meat, poultry and meat products shall not be used unless they have 

met inspection standards of state or federal authorities. 

NOTE: Authority cited: Sections 13 11. 5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of thai same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .61 . Dietetic Service-Staff. 

(a) A dietitian shall be employed on a full-time, part-time or consult- 
ing basis. Part-time or consultant services shall be provided on the prem- 
ises at appropriate times on a regularly scheduled basis. A written record 
of the frequency, naaire and duration of the consultant's visits shall be 
maintained. Staff of the dietetic service are responsible for providing diet 
counseling to the Home Health Care Services Unit and Hospice Care Ser- 
vices Unit staff and/or patients as appropriate. 

(b) If a dietitian is not employed full-time, a full-time person who is 
a graduate of a state approved course that provides 90 or more hours of 
classroom instruction in food supervision shall be employed to be re- 
sponsible for the operation of the food service. The dietetic supervisor 
may also cook, provided sufficient time is allowed for managerial re- 
sponsibilities. 

(c) Sufficient staff shall be employed, oriented, trained and their work- 
ing hours scheduled to provide for the nutritional needs of the patients 
and to maintain the dietetic service areas. If dietetic service employees 
are assigned duties in other services, those duties shall not interfere with 
the sanitation, safety or time required for dietetic work assignments. 

(d) Current work schedules by job titles and weekly time schedules by 
job titles shall be posted. 

(e) Dietetic service personnel shall be trained in basic food sanitation 
techniques, wear clean clothing, and a cap or a hair net, and shall be ex- 
cluded from duty when affected by skin infection or communicable dis- 
eases. Beards and mustaches which are not closely cropped and neatly 
trimmed shall be covered. 

(f) Employees' street clothing stored in the kitchen shall be in a closed 
area separate from food or items used in food service. 

(g) Kitchen sinks shall not be used for handwashing. Separate hand- 
washing faciUties with soap, running water and individual towels shall 
be provided. 

(h) Persons other than dietetic service personnel shall not be allowed 
in the kitchen areas unless required to do so in the performance of their 
duties. 

(i) Smoking shall not be permitted in kitchen areas. 
NOTE: Authority cited: Sections 131 1.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operadon of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .63. Dietetic Service— In-Service Training. 

In-service training shall be provided for all dietetic service personnel 

and a record of subject areas covered, data and duration of each session 

and attendance lists shall be maintained. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 



Page 1275 



(4-1-90) 



§ 97321.65 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



History 

] . New section filed 4-6-87 as an emergency; effective upon tiling. This section 
was adopted on an interim basis as authorized hy Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



§ 97321 .65. Pharmaceutical Service-General. 

(a) Arrangements shall be made to assure that pharmaceutical services 
are available to provide patients with prescribed drugs and biologicals. 

(b) Dispensing, labeling, storage and administration of drugs and bio- 
logicals shall be in conformance with state and federal laws. 

(c) If a pharmacy is located on the premises, the pharrnacy shall be h- 
censed by the California State Board of Pharmacy and approved by the 
Department. The pharmacy shall not serve the general public unless a 
separate public entrance or a separate public serving window is utilized. 
Pharmacies located on the licensed premises of Institutes shall be opened 
for inspection upon the request of an authorized Department representa- 
tive. 

(d) Tlie Institute shall not accept money, goods or services free or be- 
low cost from any pharmacist or pharmacy as compensation or induce- 
ment for referral of business to any pharmacy. 

NOTE: Authority cited: Sections 13 11 .5 and 1 31 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .67. Pharmaceutical Service-Policies and 
Procedures. 

There shall be written policies and procedures for safe and effective 
distribution, control, use and disposition of drags developed by the Pa- 
tient Care Policy Committee. The committee shall monitor implementa- 
tion of the policies and procedures and make recommendations for im- 
provement. 

NOTE: Authority cited: Sections 1311 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



§ 97321 .69. Pharmaceutical Service-Requirements. 

(a) Pharmaceutical service shall include, but is not limited to, the fol- 
lowing; 

(1) Obtaining necessary drugs including the availability of 24-hour 
prescription service on a prompt and timely basis as follows: 

(A) Drugs ordered "Stat" that are not available i the Institute emergen- 
cy drug supply shall be available and administered within one hour of the 
time ordered during normal pharmacy hours. For those hours during 
which the pharmacy is closed, drugs ordered "Stat" shall be available and 
administered within two hours of the time ordered. Drugs ordered "Stat" 
which are available in the emergency drug supply shall be administered 
immediately. 

(B) Anti-infectives and dmgs used to treat severe pain, nausea, agita- 
tion, diarrhea or other severe discomfort shall be available and adminis- 
tered within four hours of the time ordered. 

(C) Except as indicated above, all new drug orders shall be available 
on the same day ordered unless the drug would not normally be started 
until the next day. 

(D) Refill of prescription drugs shall be available when needed. 

(2) preparation for administration and dispensing of drugs and biologi- 
cals. 

(3) Monitoring the drug distribution system which includes ordering, 
dispensing and administering of medication. 



(4) Provision of consultative and other services furnished by pharma- 
cists which assist in the development, coordination, supervision and re- 
view of the pharmaceutical services within the Institute. 
NOTE: Authority cited: Sections 1 31 1.5 and 1 31 2.7, Health and Safety Code. Ref 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



§ 97321 .71 . Pharmaceutical Service-Labeling and Storage 
of Drugs. 

(a) Containers which are cracked, soiled or without secure closures 
shall not be used. Drug labels shall be legible. 

(b) All drugs obtained by prescription shall be labeled in compliance 
with state and federal laws governing prescription dispensing. No person 
other than the dispenser of the drug shall alter any prescription label. 

(c) Nonlegend drugs shall be labeled in conformance with state and 
federal food and drug laws. 

(d) Test reagents, germicides, disinfectants and other household sub- 
stances shall be stored separately from daigs and shall not be accessible 
to patients. 

(e) External use drugs in liquid, tablet, capsule or powder form shall 
be stored separately from drugs for internal use. 

(f) Drugs shall be stored at appropriate temperatures. Drugs required 
to be stored at room temperature shall be stored at a temperature between 
15"C (590F) and SO^C (Se^F). Drugs requiring refrigeration shall be 
stored in a refrigerator between 2°C (36°F) and 8°C (46°F). When drugs 
are stored in the same refrigerator with food, the drugs shall be kept in 
a closed container clearly labeled "drugs." 

(g) Drugs shall be stored in an orderly manner in cabinets, drawers or 
carts of sufficient size to prevent crowding. 

(h) Dose preparation and administration areas shall be well-lighted. 
If medication carts are used, a light shall be available on the cart. 

(i) Drugs shall be accessible only to licensed nursing personnel desig- 
nated in writing by the Institute. 

(j) Storage of nonlegend drugs at the bedside shall meet the following 
conditions: 

(1 ) The manner of storage shall prevent access by other patients. Lock- 
able drawers or cabinets need not be used unless alternate procedures, in- 
cluding storage on a patient's person or in an unlocked drawer or cabinet 
are ineffective. 

(2) The Institute shall record in the patient's Unit health record the bed- 
side medications used by the patient, based on observation by nursing 
personnel and/or information supplied by the patient. 

(3) The quantity of each drug supplied to the patient for bedside stor- 
age shall be recorded in the patient's Unit health record each time the 
drug is so supplied. 

(k) Storage of legend drugs at the bedside shall meet the conditions of 
97321. 71(j) and shall in addition: 

(1) Be specifically ordered by the prescriber of the drugs, and 

(2) Be limited to sublingual or inhalation forms of emergency dugs. 
(I) Drugs shall not be kept in stock after the expiration date on the label 

and no contaminated or deteriorated drugs shall be available for use. 

(m) The drugs of each patient shall be kept and stored in their original- 
ly received containers. No drug shall be transferred between containers. 

(n) Discontinued drug containers shall be marked, or otherwise identi- 
fied, to indicate that the drug has been discontinued, or shall be stored in 
a separate location which shall be identified solely for this purpose. Dis- 
continued drugs shall be disposed of within 90 days of the date the drug 
order was discontinued, unless the drug is reordered within that time. 
NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 3 12 .7 , Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 

was adopted on an interim basis as authorized by Health and Safety Code Sec- 



Page 1276 



(4-1-90) 



Title 22 



Health Planning and Facility Construction 



§ 97321.87 



tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .73. Pharmaceutical Service — Standing Orders. 

The Institute shall not use any standing order for medications or treat- 
ment. 

NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .75. Pharmaceutical Service — Stop Orders. 

Written policies shall be established and implemented limiting the du- 
ration of new drug orders in the absence of a prescriber's specific indica- 
tion for duration of therapy. The prescriber shall be contacted for new or- 
ders prior to the termination time established by the policy. Such policies 
shall include all categories of drugs. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .77. Pharmaceutical Service— Orders for Drugs. 

(a) No drugs shall be administered except upon the order of a person 
lawfully authorized to prescribe for and treat human illness. 

(b) All drug orders shall be written, dated, and signed by the person 
lawfully authorized to give such an order. The name, quantity or specific 
duration of therapy, dosage and time or frequency of administration of 
the drug, the site of injection when indicated, and the route of administra- 
tion if other than oral shall be specified. "P.R.N." orders shall also in- 
clude the indication for use of a drug. 

(c) Verbal orders for drugs and treatments shall be received only by 
licensed nurses, psychiatric technicians, pharmacists, physicians, physi- 
cian's assistants from their supervising physicians only, and certified re- 
spiratory therapists when the orders relate specifically to respiratory 
care. Such orders shall be recorded immediately in the patient's Unit 
health record by the person receiving the order and shall include the date 
and time of the order. The order shall be signed by the prescriber within 
five days. 

(d) The signing of orders shall be by signature or a personal computer 
key. Signature stamps shall not be used. 

NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321.79. Pharmaceutical Service — Drug Order 
Processing. 

Signed orders for drugs shall be transmitted to the issuing pharmacy 
within 48 hours, either by written prescription of the prescriber or by an 
order form which produces a direct copy of the order or by an electroni- 
cally reproduced facsimile. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1 312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .81 . Pharmaceutical Service — Drug Order Records. 

Institutes shall maintain a record which includes, for each drug or- 
dered by prescription, the name of the patient, the drug name, and 



strength, the date ordered, the date and amount received and the name of 
the issuing pharmacy. The records shall be kept at least one year. 
NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .83. Pharmaceutical Service — Personal 
Medications. 

(a) Medications brought by or with the patient on admission to the In- 
stitute shall not be used unless the drugs have been ordered by the pa- 
tient's physician and contents of the containers have been examined and 
positively identified after admission by the pafient's physician or a phar- 
macist retained by the Institute. 

(b) The Institute may use drugs transferred from licensed health facili- 
ties or those drugs dispensed or obtained after admission from any li- 
censed or governmental pharmacy and may accept the delivery of those 
drugs by any agent of the pafient or pharmacy without the necessity of 
identificafion by a physician or pharmacist. 

NOTE: Authority cited: Sections 131 1.5 and 13 12.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .85. Pharmaceutical Service — Controlled Drugs. 

(a) Drugs hsted in Schedules II, III and IV of the Federal Comprehen- 
sive Drug Abuse Prevention and Control Act of 1970 shall not be accessi- 
ble to other than licensed nursing, pharmacy and medical personnel des- 
ignated by the Institute. The Director of Nursing Services shall be 
designated to be responsible for the control of such drugs. Drugs listed 
in Schedule II of the above Act shall be stored in a locked cabinet or a 
locked drawer separate from noncontrolled drugs unless they are 
supplied on a scheduled basis as part of a unit dose medication system. 

(b) Separate records of use shall be maintained on all Schedule II 
drugs. Such records shall be maintained accurately and shall include the 
name of the padent, the prescriber, the prescription number, the drug 
name, strength and dose administered, the date and time of administra- 
tion and the signature of the person administering the drug. Such records 
shall be reconciled at least dmly and shall be retained at least one year. 
If such drugs are supplied on a scheduled basis as part of a unit dose medi- 
cation system, such records need not be maintained separately from pa- 
tient's medication records. 

(c) Drug records shall be maintained for drugs listed in Schedules III 
and IV of the above Act in such a way that the receipt and disposition of 
each dose of any such drug may be readily traced. Such records need not 
be separate from other medication records. 

NOTE; Authority cited: Sections 131 1.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .87. Pharmaceutical Service — Disposition of Drugs. 

(a) Drugs which have been dispensed for individual patient use and are 
labeled in conformance with State and Federal law for outpatient use 
shall be furnished to patients on discharge on the orders of the discharg- 
ing physician. Such drugs shall be dispensed in compliance with the Cali- 
fornia Pharmacy Laws and Regulations. If the physician's discharge or- 
ders do not include provisions for drug dispositions, drugs shall be 
furnished to patients unless: 

(1) The discharging physician specifies otherwise or, 



Page 1277 



(4-1-90) 



§ 97321.89 



BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



(2) The patient leaves or is discharged without a physician's order or 
approval or, 

(3) The patient is discharged to a general acute care hospital, acute psy- 
chiatric hospital, or acute care rehabilitation hospital or, 

(4) The drug was discontinued prior to discharge or, 

(5) The labeled directions for use are not substantially the same as most 
current orders for the drug in the patient's Unit health record. 

(b) A record of the drugs sent with the patient shall be made in the pa- 
tient' s Unit health record. 

(c) Patient's drugs supplied by prescription which have been discon- 
tinued and those which remain in the Institute after discharge of the pa- 
tient shall be destroyed by the Institute in the following manner: 

(1) Drugs listed in Schedules II, III or IV of the Federal Comprehen- 
sive Drug Abuse Prevention and Control Act of 1970 shall be destroyed 
by the Institute in the presence of a pharmacist and a registered nurse 
employed by the Institute. The name of the patient, the name and strength 
of the drug, the prescription number, the amount destroyed, the date of 
destruction and the signatures of the witnesses required above shall be 
recorded in the patient's Unit health record or in a separate log. Such log 
shall be retained for at least three years. 

(2) Drugs not listed under Schedules II, III or IV of the Federal Com- 
prehensive Drug Abuse Prevention and Control Act of 1970 shall be de- 
stroyed by the Institute in the presence of a pharmacist or licensed nurse. 
The name of the patient, the name and strength of the drug, the prescrip- 
tion number if applicable, the amount destroyed, the date of destruction 
and the signatures of the pharmacist or licensed nurse and one other per- 
son shall be recorded in the patient' s Unit health record or in a separate 
log. Such log shall be retained for at least three years. 

(d) Unless otherwise prohibited under applicable federal or state laws, 
individual patient drugs supplied in sealed containers may be returned, 
if unopened, to the issuing pharmacy for disposition provided that: 

(1) No drugs covered under the Federal Comprehensive Drug Abuse 
Prevention and Control Act of 1970 are returned. 

(2) All such drugs are identified as to lot or control number. 

(3) The signatures of the receiving pharmacist and a registered nurse 
employed by the Institute are recorded in a separate log which lists the 
name of the patient, the name, strength, prescription number (if applica- 
ble), the amount of the drug returned and the date of return. The log must 
be retained for at least three years. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321.89. Pharmaceutical Service — Unit Dose 
Medication System. 

In Institutes utilizing a unit dose medication system, there shall be at 
least a 24-hour supply of all patient medications on hand at all times, ex- 
cept those dmgs which are to be discontinued within the 24-hour period. 
Drugs that are part of a unit dose medication system shall not exceed a 
48-hour supply. 

NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .91 . Pharmaceutical Service — Staff. 

(a) The Institute shall retain a consulting pharmacist who devotes a 
sufficient number of hours during a regularly scheduled visit, for the pur- 
pose of providing consultation on methods and procedures for ordering, 
storage, administration and disposal and record keeping of drugs and bio- 
logicals and coordinating, supervising and preparing a report to the Phar- 



maceutical Service Committee, or its equivalent, at least quarterly. The 
report shall include a log or record of time spent in the Institute. There 
shall be a written agreement between the pharmacist and the Institute 
which includes duties and responsibilities of both. 

(b) A pharmacist shall serve on the Pharmaceutical Service Commit- 
tee and the Patient Care Policy Committee. 

(c) A pharmacist shall review the daig regimen of each patient at least 
monthly. The review of the drag regimen of each patient shall include all 
drugs currently ordered, information concerning the patient's condition 
relating to drug therapy, medication administration records and where 
appropriate, physician's progress notes, nurse's notes, and laboratory 
test results. The pharmacist shall be responsible for reporting, in writing, 
irregularities in the dispensing and administration of drugs and other 
matters relating to the review of the drug regimen to the Institute adminis- 
trator and the Director of Nursing Services. 

NOTE: Authority cited: Sections 131 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

I . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .93. Pharmaceutical Service — Equipmient and 
Supplies. 

(a) There shall be adequate equipment and supplies necessary for the 
provision of pharmaceutical services within the Institute including at 
least the following: 

(1) Refrigerator with an accurate thermometer. 

(2) Lockable drug cabinets, drawers, closets or rooms. 

(3) Drag service trays and/or carts. 

(4) Drag preparation counter area and convenient water source. 

(5) Syringes, needles, rabber tubing, clamps, droppers, medicine 
glasses, cups or other small containers which are accurately calibrated. 

(6) Reference materials containing drag monographs on all drags in 
use in the Institute. Such monographs shall include information concern- 
ing generic and brand names, if applicable, available strengths and dos- 
age forms and pharmacological data including indications and side ef- 
fects. 

(b) Emergency supplies as approved by the Patient Care Policy Com- 
mittee or Pharmaceutical Service Committee shall be readily available 
to each nursing station. Emergency drag supplies shall meet the follow- 
ing requirements: 

(1) Legend drags shall not be stored in the emergency supply, except 
under the following conditions: 

(A) Injectable supplies of legend drags shall be limited to a maximum 
of three single doses in ampules or vials or one container of the smallest 
available multi-dose vial and shall be in sealed, unused containers. 

(B) Sublingual or inhaladon emergency drags shall be limited to single 
sealed containers of the smallest available size. 

(C) No more than six emergency drags in solid, oral dosage form or 
suppository dosage form for anti-infective, antidiarrheal, antinausea, or 
analgesic use may be stored if in sealed containers. Not more than four 
doses of any one drag may be so stored. 

(2) The emergency drag supply shall be stored in a portable container 
which is sealed in such a manner that the tamper-proof seal must be bro- 
ken to gain access to the drags. The supply shall be opened only in the 
presence of a physician, pharmacist or licensed nurse. The Director of 
Nursing Services or charge nurse shall notify the pharmacist when drags 
have been used from the emergency kit or when the seal has been broken. 
Drags used from the kit shall be replaced within 72 hours and the supply 
resealed by the pharmacist. 

(3) The contents of the supply shall be listed on the outside of the con- 
tainer. 

(4) The supply shall be checked at least monthly by the pharmacist. 

(5) Separate records of use shall be maintained for drugs administered 
from the supply. Such records shall include the name and dose of the drag 



Page 1278 



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Title 22 



Health Planning and Facility Construction 



§ 97321.99 



• 



administered, name of tiie patient, the date and time of administration and 
the signature of the person administering the dose. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 13 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4—6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Heahh and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



§ 97321 .95. Activity Program — Requirements. 

(a) The activity program and all additional programs in Section 
97321.105 shall be under the management of the Institute administrator 
and shall be available to provide services to patients in Services Units 
which do not have an individual program within the Unit, as indicated by 
the needs of the patients. 

(b) Patients shall be encouraged to participate in activities planned to 
meet their individual needs. An activity program shall have a written, 
planned schedule of social and other purposeful independent or group ac- 
tivities. The program shall be designed to make life more meaningful, to 
stimulate and support physical and mental capabilities to the fullest ex- 
tent, to enable the patient to maintain the highest attainable social, physi- 
cal and emotional functioning but not necessarily to correct or remedy a 
disability. 

(c) The activity program shall consist of individual, small and large 
group activities which are designed to meet the needs and interests of 
each patient and which include, but are not limited to: 

(1) Social activities which involve group participation and are de- 
signed to promote group relationships. 

(2) Indoor and out-of-doors activities, which may include supervised 
daily walks. 

(3) Recreational activities, both indoor and outdoor. 

(4) Activities away from the Institute. 

(5) Religious programs including the right of each patient to attend the 
church or religious program of his or her choice. 

(6) Opportunity for patient involvement for planning and implementa- 
tion of the activity program. 

(7) Creative and expressive activities. 

(8) Educational activities. 

(9) Exercise activities. 

(d) Activities shall be available on a daily basis. 

(e) The activity leader, at a minimum, shall: 

(1) Develop, implement and supervise the activity program. 

(2) Plan and conduct in-service training of the staff of the Institute at 
least annually. 

(3) Coordinate the activity schedule with other patient services. 

(4) Maintain a current list of patients from the nursing service who are 
not physically able to participate in activities. 

(5) Post the activity schedule conspicuously, in large visible print, for 
the information of patients and staff. 

(6) Request and maintain equipment and supplies. 

(7) Develop and maintain contacts with community agencies and or- 
ganizations. 

(8) Develop and implement activities for patients unable to leave their 
rooms. 

(9) Maintain progress notes specific to the patient's activity plan 
which are recorded at least quarterly, and more frequently if needed, in 
the patient's Unit health record. 

(10) Maintain a current record of the type and frequency of activities 
provided and the names of patients participating in each activity. 

(11) Provide the administrator with a current schedule of planned acti- 
vities. 

(d) Where appropriate, the activity leader may recruit, train and super- 
vise a volunteer program to assist with and augment the services of the 
activity program. 

NOTE: Authority cited: Sections 13 11. 5 and 131 2.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 



History 

1 . New section filed 4-6-87 as an emergency; effective upon fihng. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .97. Activity Program— Activity Plan. 

(a) An activity plan shall; 

(1) Be developed and implemented for each patient and shall be inte- 
grated with the individual treatment and management plan and patient's 
care plan. 

(2) Be reviewed quarterly and approved, in writing, by the attending 
physician as not in conflict with the treatment and management plan. 

NOTE: Authority cited: Sections 1 31 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4—6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .98. Activity Program— Staff . 

(a) Activity program personnel with appropriate training and experi- 
ence shall be available to meet the needs and interests of patients. 

(b) An activity program leader shall be designated by and be responsi- 
ble to the Institute administrator. An activity program leader shall meet 
one of the following requirements: 

(1) Have two years of experience in a social or recreational program 
within the past five years, one year of which was full-time in a patient 
activities program in a health care setting. 

(2) Be an occupational therapist, art therapist, music therapist, dance 
therapist, recreation therapist or occupational therapy assistant. 

(3) Have satisfactorily completed at least 36 hours of training in a 
course designed specifically for this position and approved by the De- 
partment and shall receive regular consultation from an occupational 
therapist, occupational therapy assistant or recreation therapist who has 
at least one year of experience in a health care setting. 

(c) As a minimum, the Institute shall provide an activity leader as fol- 
lows: 

(1) Any Institute with 50 or more skilled nursing or intermediate care 
beds shall have a full-time employee whose sole responsibility shall be 
the development, implementation and supervision of the social, recre- 
ational and rehabilitative programs at the Institute. 

(2) Any Institute with 25 or more, but less than 50 skilled nursing or 
intermediate care beds shall have an employee who shall devote a mini- 
mum of 20 hours per week to the development, implementation and su- 
pervision of the social, recreational and rehabilitative programs of the In- 
stitute. 

(3) Any Instimte with less than 25 skilled nursing or intermediate care 
beds shall have an employee or consultant who shall devote a minimum 
of 10 hours per week to the development, implementation and supervi- 
sion of the social, recreational and rehabilitative programs of the Insti- 
tute. 

NOTE: Authority cited: Sections 1311.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .99. Activity Program— Equipment and Supplies. 

Each Institute shall provide equipment and supplies for both indepen- 
dent and group activities and for patients having special needs. 
NOTE: Authority cited: Sections 131 1.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Secfion 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 



Page 1279 



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Title 22 



§ 97321 .1 01 . Activity Program— Space. 

(a) Each Institute shall provide designated activity areas both indoor 
and outdoor, which meet the independent and group activity needs of pa- 
tients. Such areas shall be: 

(1) Accessible to wheelchair and ambulatory patients. 

(2) Of sufficient size to accommodate necessary equipment and permit 
unobstaicted movement of wheelchair and ambulatory patients or per- 
sonnel responsible for instruction and supervision. 

(b) Storage space for equipment and supphes shall be provided and 
shall be maintained in a clean and orderly manner. 

NOTE: Authority cited: Sections 131 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 03. Activity Program — Policies and Procedures. 

Written policies and procedures governing the conduct of the activity 
program shall be available for use by the activity leader and other person- 
nel assisting in the prograin. The policies and procedures shall be devel- 
oped by the Patient Care Policy Committee with the assistance of the ac- 
tivity leader. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 1 5). 

§ 97321.105. Additior^ai Programs— General. 

(a) Additional program means a functional program of an Institute 
which is organized, staffed and equipped to provide a specific type or 
types of patient care. 

(b) The following types of additional programs shall be operated in an 
Institute: physical therapy, occupational therapy, speech therapy, speech 
pathology, audiology, and social work services. 

(c) If additional programs offer services to outpatients, the following 
conditions shall be met: 

(1) Program areas shall be located or constructed in a manner that will 
minimize noise, odors, hazards and unsightliness to the Institute's inpa- 
tients. 

(2) Outpatient access to program areas shall not traverse a nursing unit. 

(3) Separate toilets for men and women outpatients shall be provided. 

(4) Drinking water facilities of a type approved by the Department 
shall be available for outpatients and personnel. 

(5) Handwashing facilities with hot and cold water supply shall be pro- 
vided in the program areas accommodating outpatients. 

(6) Waiting areas shall be provided with sufficient floor space to seat 
the maximum number of patients who are expected to be accommodated 
at any one time. 

(d) Each additional program within the Institute shall be approved by 
the Office. 

(e) The Office shall list on the Designation Certificate each additional 
program for which approval is granted. 

NOTE: Authority cited: Sections 1 31 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321.107. Physical Therapy Program— Services. 

(a) Physical therapy program means those services ordered by a physi- 
cian for a patient or upon a physician's referral and provided to a patient 
by or under the supervision of a physical therapist to achieve and main- 
tain the highest level of functional ability. 

(b) Physical therapy services shall include but are not limited to: 



(1) Assisting the physician in an evaluation of the patient's rehabilita- 
tion potential. 

(2) Applying muscle, nerve, joint and functional ability tests. 

(3) Treating patients to relieve pain and to develop or restore function. 

(4) Assisting patients to achieve and maintain maximum performance 
using physical means such as exercise, massage, heat, sound, water, light 
or electricity. 

(5) Establishing and modifying a treatment program by the physical 
therapist, as needed, based upon initial and continuing assessment of the 
patient. 

(6) Maintaining patient health records which contain pertinent infor- 
mation and signed orders for treatment. 

(A) Notes shall be written and entered in the patient's Unit health re- 
cord after completion of each procedure. The note shall indicate the pro- 
cedure(s) and shall be signed by the physical therapist. 

(B) Initial and continuing assessment, development of a care plan shall 
be written and entered in each patient's Unit health record. 

(C) Individual progress notes shall be written and signed at least week- 
ly by the physical therapist. 

(D) When hydrotherapy is offered, there shall be written cleaning and 
culturing techniques posted near the equipment. 

(E) Personnel policies shall define the responsibilities of the physical 
therapy director and the duties assigned to the auxiliary personnel. 
NOTE: Authority cited: Sections 131 1.5 and 1 312.7, Health and Safety Code. Ref 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 09. Physical Therapy Program— Policies and 
Procedures. 

(a) Each physical therapy program shall have written policies and pro- 
cedures for the management of the physical therapy program. 

(b) The policies and procedures shall be established and implemented 
by the Patient Care Policy Committee in consultation with a physical 
therapist. 

NOTE: Authority cited: Sections 131 1.5 and 1 312.7, Health and Safety Code. Ref 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4—6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .111. Physical Therapy Program— Staff. 

(a) The physical therapy program shall be under the direction of a 
physical therapist. 

(b) A physical therapist assistant shall treat patients only under the su- 
pervision of a physical therapist in accordance with Article 4.5 (begin- 
ning with Section 2655) of the Physical Therapy Act, Chapter 5.7 of Di- 
vision 2 of the Business and Professions Code. 

(c) A physical therapy aide shall work only under the direct supervi- 
sion of a physical therapist. 

(d) There shall be a physical therapist, physical therapist assistants and 
physical therapy aides to meet the identified needs of the patients and 
staff shall work the hours necessary to accomplish those tasks listed in 
Section 97321.107. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 1 3. Physical Therapy Program — Equipment. 

(a) Equipment shall be sufficient to provide the physical therapy ser- 
vices offered. The equipment shall include but not be limited to: 



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§ 97321.125 



• 



• 



(1) Parallel bars. 

(2) Full view mirror. 

(3) Overhead pulley and weights. 

(4) Set of training stairs. 

(5) Treatment table enclosed by cubicle curtains for privacy. 

(6) Availability of wheelchairs, walkers, canes, crutches and other am- 
bulation aids. 

NOTE: Authority cited: Sections 1 3 11 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1 3 1 2.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .115. Physical Therapy Program — Space. 

(a) Adequate space shall be maintained for the necessary equipment 
needed to provide physical therapy services. The minimum floor area for 
physical therapy service shall be 28 square meters (300 square feet), no 
dimension of which shall be less than 3.7 meters (12 feet). 

(b) A sink shall be provided in the treatment area and shall have con- 
trols other than hand controls. 

(c) The toilet facilities shall be located nearby and equipped with grab 
bars on both side of the commode and the space shall be of sufficient size 
to allow for patient transfer activities. 

NOTE: Authority cited: Sections 13 11. 5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 1 7. Occupational Therapy Program— Services. 

(a) Occupational therapy program means those medically prescribed 
services in which selected purposeful activity is used as treatment in the 
rehabilitation of persons with a physical or mental disabiHty. 

(b) Occupational therapy services shall include but not be limited to: 

( 1 ) Assisting the physician in an evaluation of a patient's level of func- 
tion by applying diagnostic and prognostic tests. 

(2) Conducting and preparing written initial and continuing asses- 
sment of the patient' s condition and modifying treatment goals under the 
order of a physician, consistent with the identified needs of the patient. 

(3) Decreasing or eliminating disability during patient's initial phase 
of recovery following injury or illness. 

(4) Increasing or maintaining a patient's capability for independence. 

(5) Enhancing a patient's physical, emotional and social well-being. 

(6) Developing function to a maximum level. 

(7) Guiding patients in their use of therapeutic, creative and self-care 
activities for improving function. 

(c) An occupational therapy service unit shall meet the following re- 
quirements: 

(1) Patient's care plan shall contain pertinent information and signed 
orders for treatment. 

(2) Notes shall be written and entered in the patient's Unit health re- 
cord after completion of each procedure. The notes shall indicate the pro- 
cedure(s) performed, the reaction of the patient to the procedure(s) and 
shall be signed by the occupational therapist. 

(3) Initial and continuing assessment, consultation in the development 
of a treatment and development plan shall be written and entered in each 
patient's care plan. 

(4) Individual progress notes shall be written and signed on each visit 
or at least weekly by the occupational therapist. 

(5) Personnel policies shall define the occupational therapy director's 
responsibilities and the duties assigned to the occupational assistant. 
Staff shall work the hours necessary to accomplish the tasks listed in Sec- 
tion 97321.117. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 



HfSTORY 
1 . New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 1 9. Occupational Therapy Program — Policies and 
Procedures. 

(a) Each occupational therapy program shall have written policies and 
procedures for the management of the occupational therapy program. 

(b) The policies and procedures shall be established and implemented 
by the Patient Care Policy Committee in consultation with an occupation- 
al therapist. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 21 . Occupational Therapy Program — Staff. 

(a) The occupational therapy program shall be under the direction of 
an occupational therapist. 

(b) An occupational therapy assistant shall work only under the super- 
vision of an occupational therapist. 

(c) There shall be occupational therapists and occupational therapy as- 
sistants in the number necessary to meet the identified needs of the pa- 
tients. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 23. Occupational Therapy Program — Equipment. 

(a) Necessary equipment shall be available to provide the occupational 
therapy services offered. The equipment shall include but not be limited 
to: 

(1) Supportive slings, supportive and assistive hand splints and the 
materials from which to fabricate these and other assisfive devices. 

(2) Adaptive devices to aid in the performance of daily living skills 
such as eating, dressing, grooming and wrifing, with instrucdons for their 
use. 

(3) Equipment and supplies for the development of creadve skills shall 
include, but not Hmited to, leatherwork, weaving, needlework, ceramics, 
woodworking, painting, and graphic arts. 

(4) Means and supplies for adapting equipment for reeducation in acti- 
vities of daily hving. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 25. Occupational Therapy Program — Space. 

(a) Space shall be provided for the necessary equipment needed to pro- 
vide occupational therapy. The minimum floor area shall be 28 square 
meters (300 square feet), no dimension of which shall be less than 3.7 me- 
ters (12 feet). 

(b) A sink shall be provided in the treatment area and shall have con- 
trols not requiring the use of hands. 

(c) The toilet facilities shall be located nearby and equipped with grab 
bars on both sides of the commode, and the space shall be of sufficient 
size to allow for patient transfer activities. 

NOTE: Authority cited: Sections 1 31 1.5 and 1312.7, Health and Safety Code. Ref- 
erence; Section 1312, Health and Safety Code. 

History 
1. New section filed 4—6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 



Page 1281 



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BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 27. Speech Pathology and/or Audiology 
Program — Services. 

(a) Speech pathology and/or audiology services means those services 
referred or ordered hy a physician which provide diagnostic screening 
and preventive and corrective therapy for patients with speech, hearing 
and/or language disorders. 

(b) Speech pathology and/or audiology service shall include but not be 
limited to the following: 

(1) Conducting and preparing written initial and continuing asses- 
sment of a patient. 

(2) Notes written and entered in the patient's Unit health record after 
each treatment. The notes shall indicate the treatment performed, the 
reaction of the patient to the treatment, and be signed by the speech pa- 
thologist or audiologist. 

(3) Instruction of other health team personnel and family members in 
methods of assisting the patient to improve or correct a speech or hearing 
disorder. 

(4) Determination and recommendation of the appropriate speech, 
language and hearing therapy. 

(c) A speech pathology and/or audiology program shall meet the fol- 
lowing requirements: 

(1) The patient's care plan shall contain a patient's history and signed 
orders for treatment. 

(2) Progress notes shall be written at least weekly and entered in the 
patient's Unit health record and shall be signed by the speech pathologist 
and/or audiologist. 

(3) Personnel policies shall define the duties of the speech pathology 
and audiology director and allied personnel in the speech and audiology 
program. Staff shall work the hours necessary to accomplish the tasks in 
this program. 

NOTE; Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 29. Speech Pathology and/or Audiology 
Program — Policies and Procedures. 

(a) Each speech pathology and/or audiology program shall have writ- 
ten policies, procedures and job descriptions for the management of the 
speech pathology and/or audiology service. 

(b) The policies, procedures and job descriptions shall be established 
by the Patient Care Policy Committee in consultation with a speech pa- 
thologist and/or audiologist. 

NOTE; Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 31 . Speech Pathology and/or Audiology 
Program — Staff. 

(a) Each speech pathology program shall employ a speech pathologist 
and/or audiologist for a sufficient number of hours to meet the needs of 
the patients. 

(b) There may be at least one speech pathology and/or audiology aide 
to assist in the testing and implementation of the service. The aides shall 
be registered as speech pathology and/or audiology aides with the Board 
of Medical Examiners and shall work only under the supervision of a 
speech pathologist and/or audiologist. 

NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 



History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 33. Speech Pathology and/or Audiology 
Program — Equipment. 

(a) Necessary equipment shall be available to provide the speech pa- 
thology and/or audiology services offered. The equipment shall include 
but not be limited to: 

(1) A diagnostic clinical audiometer. 

(2) Diagnostic tests and materials. 

(3) Other equipment and materials deemed necessary by the speech 

pathologist and/or audiologist to ineet the needs of patients. 

NOTE; Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 35. Speech Pathology and/or Audiology 
Program — Space. 

Space free of ambient noise shall be provided by the institute to pro- 
duce valid test results. 

NOTE; Authority cited: Sections 1 3 II .5 and 1312.7, Health and Safety Code. Ref- 
erence: Secdon 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effecnve 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 37. Social Work Program— Services. 

(a) Social work services means those services which assist staff, a pa- 
tient and a patient's family to understand and cope with a patient's per- 
sonal, emotional and related health and environmental problems. 

(b) The social work program shall include but not be limited to the fol- 
lowing: 

(1) Interview and written assessment of each patient within five days 
after admission to the program. 

(2) Weekly progress reports in the patient's Unit health record written 
and signed by the social worker, social work assistant or social work aide. 

(3) Social work program staff will participate in regular staff confer- 
ences with the attending physicians, the Director of Nursing Service and 
other appropriate personnel. 

(4) Social work program staff will participate in the orientation and in- 
service education of other Institute staff assist in the recognition and un- 
derstanding of the emotional problems and social needs of patients and 
families and to learn how to implement appropriate action to meet such 
identified needs. 

NOTE; Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .139. Social Work Program— Policies and 
Procedures. 

(a) Each social work program shall have written policies, procedures 
and job descriptions for the management of the social work program. 

(b) The policies, procedures and job descriptions shall be established 
by the Patient Care PoHcy Committee in consultation with a social work- 
er. 

NOTE; Authority cited: Sections 1311 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 



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§ 97322.1 



tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .141 . Social Work Program— Staff. 

(a) Each social work program shall employ a staff for the number of 
hours necessary to meet the needs of the patients. 

(b) The social work program shall be organized, directed and super- 
vised by a social worker, who is responsible for supervision of other so- 
cial work staff, including social work assistants and social work aides. 

(c) Social work program staff may include the social work assistant or 
the social work aide. Assigned functions and tasks shall be supervised by 
the social worker. Under conditions specified in the written patient care 
policies, procedures and job descriptions, the social work aide may be 
under the supervision of the social work assistant. 

(d) Adequate clerical support services shall be provided for social 
work staff, including those employed on a contractual basis. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .143. Social Work Service Program — Equipment 
and Supplies. 

(a) Office equipment and supplies necessary for the social work pro- 
gram shall be available. 

(b) Equipment and supplies shall include but not be limited to: 

(1) Literature and references on subjects including psychosocial prob- 
lems and needs of the patient population in the Institute. 

(2) Directories, listings and other reference materials on available 
community resources. 

(3) Necessary clerical equipment and supplies. 

NOTE: Authority cited: Secfions 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 45. Social Work Program— Space. 

Adequate office and other accessible space shall be provided for priva- 
cy in interviewing, telephoning, conferences and for operation of the pro- 
gram. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .147. Psychiatric or Psychological Services 
Program. 

(a) The Institute shall have consultant staff available at a minimum of 
three hours per month and consisting of a psychiatrist, clinical psycholo- 
gist, psychiatric social worker or psychiatric nurse. For proposes of this 
Section, a psychiatric nurse shall meet either of the following require- 
ments: 

(1) Be a registered nurse with a graduate degree in psychiatric nursing 
and one year of psychiatric nursing experience within the past five years. 

(2) Be a registered nurse with a baccalaureate degree in nursing and 
three years of psychiatric nursing experience in a acute psychiatric set- 
ting or in a psychiatric health facility, one year of which shall have been 
within the past five years. 

(b) The consultant shall provide at least the following: 

(1) Maintenance of signed progress reports in the patient's Unit health 
record when indicated. 



(2) Liaison with other members of the unit staff and family members 
and referral agencies that may yield information for psychiatric and psy- 
chological treatment. 

(3) Group counseling and techniques, as indicated by the patient's 
needs. 

(c) Sufficient space shall be provided for privacy for individual or 
small group counseling or large group activities as indicated by the pa- 
tient's needs. 

(d) Consultant staff shall spendasufficientnumberofhoursintheUnit 
to meet the needs of each patient and the staffing requirements of the De- 
partment. 

(e) The Department may require that the Institute employ additional 
staff and/or consultants in this program if it determines on the basis of a 
written evaluation that such additional staff and/or consultants are need- 
ed to meet the needs of the patients. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97321 .1 49. Transportation Services Program. 

(a) An Institute which provides direct transportation services for pa- 
tients shall meet specific operational standards. The motor vehicle shall: 

(1) Be operated only by drivers who have a current license from the 
California State Department of Motor Vehicles and who meet the provi- 
sions of Section 12804 of the California Vehicle Code. 

(2) Be equipped with safety devices to protect patients during trans- 
portation. 

(3) Be equipped to accommodate patients with physical disabilities 
and patient's special equipment. 

(4) Be maintained in a safe and reliable condition. 

(b) The Institute shall develop policies regarding transportation safety 
and maintenance of vehicles. 

NOTE: Authority cited: Sections 1311.5 and 131 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



Article 3. Staff 



§ 97322.1 . Administrator. 

(a) Each Institute shall employ or otherwise provide a qualified full- 
time administrator to carry out the policies of the designee. 

(b) The administrator shall have sufficient freedom from other respon- 
sibilities and shall be on the premises of the Institute a sufficient number 
of hours to permit adequate attention to the management and administra- 
tion of the Institute. The Department may require that the administrator 
spend additional hours in the Institute whenever the Department deter- 
mines through a written evaluation that such additional hours are needed 
to provide adequate administrative management. 

(c) The designee shall employ an adequate number of qualified per- 
sonnel to carry out all the functions of the Institute and shall provide for 
initial orientation of all new employees and a continuing in-service train- 
ing program and competent supervision of all employees. 

(d) If language or communication barriers exist between Institute and/ 
or program staff and patients, arrangements shall be made for interpret- 
ers, bilingual staff or for the use of other mechanisms to ensure adequate 
communication between patients and personnel. 

(e) The designee shall ensure that all employees serving patients or the 
public shall wear name and title badges unless contraindicated. 



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Title 22 



(f) A copy of the current Institute regulations contained in this Chapter 
shall be maintained by the administrator and shall be available to all per- 
sonnel. 

(g) The administrator shall be responsible for informing appropriate 
staff of the applicable additions, deletions and changes to the regulations. 

(h) The administrator shall be responsible for informing the Depart- 
ment via telephone within 24 hours of any unusual occurrences as speci- 
fied in Section 97323.15. If the unusual occurrence involves the discon- 
tinuance or disruption of services occurring during other than regular 
business hours of the Department or its designee, a telephone report shall 
be made immediately upon the resumption of business hours of the De- 
partment. 

NOTE: Authority cited: Sections 13 II. 5 and 13 12.7, Health and Safety Code. Ref- 
erence: Section 131 1 .5, Health and Safety Code. 

History 
] . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interiin basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register87, No. 13). 

§ 97322.3. Institute Staff. 

An Institute must have at least the following principal staff: 

(a) Medical Director. A physician who shall be responsible for the 
overall medical care program, the assignment of each patient to a case 
manager, and approval of all admissions and discharges, and who may 
also be considered the admitting physician. 

(b) Administrator. An individual who shall be responsible for adminis- 
trative management. 

(c) Research Coordinator. A professional level staff person who shall 
be responsible for the identification, collection, maintenance, and avail- 
ability of information relative to Alzheimer's disease or related demen- 
tias for the use of staff, the public, and researchers, so as to facilitate op- 
portunities for basic and clinical research to implement the purposes of 
Health and Safety Code Section 1310.3. 

(d) Education Director. An individual who shall be responsible for the 
coordination of educational development for Institute staff, health sci- 
ence students and patients' families, and/or other caregivers. 

(e) Program Administrator. An individual who shall be responsible for 
the operation of a type of services and patients assigned to receive that 
type of services. A person may be a program administrator for more than 
one type of services if approved by the Department. 

(f) Director of Nursing Services. An individual who shall have overall 
responsibility for the supervision of nursing services in the Institute. 

(1) The Director of Nursing Services shall be a registered nurse and 
shall be employed full time in the Institute, eight hours a day, on the day 
shift five days a week. 

(2) The Director of Nursing Services shall have at least one year of ex- 
perience in nursing supervision within the last five years. 

(3) The Director of Nursing Services shall have, in writing, adminis- 
trative authority, responsibility and accountability for the nursing ser- 
vices within the Institute. 

(4) The Director of Nursing Services shall not have charge nurse re- 
sponsibilities. 

(g) Case Managers. Individuals who shall serve as advocates for as- 
signed patients and their families and/or caregivers to help assure that a 
continuum of care is provided and that the patients and their families and/ 
or caregivers receive appropriate services. 

NOTE: Authority cited: Sections 1 3 11 .5 and 1 3 1 1 .7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97322.5. Case Management. 

Each patient shall have a case manager assigned by written order of the 
Medical Director. The case manager shall provide continuous oversight 
and monitoring of the status of the assigned patient and his or her family 



and/or caregiver and serve as an advocate to help assure that a continuum 
of care is provided in accordance with the treatment and management 
plan. Each case manager shall be assigned only that number of patients 
for whom the case manager can provide adequate oversight and monitor- 
ing. The Department may require that more case managers he employed 
if the Department determines on the basis of a written evaluation that 
more case managers are needed. 

NOTE: Authority cited: Sections i 312 and 1 312.7, Health and Safety Code. Refer- 
ence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97322.7. Staff Development. 

(a) Each Institute shall have an ongoing educational and training pro- 
gram planned and conducted for the development and improvement of 
necessary skills and knowledge of all Institute personnel. Each program 
shall include but not be limited to: 

(1) Problems and needs of aged, chronically ill, acutely ill and disabled 
patients, especially those with Alzheimer's disease and related demen- 
tias. 

(2) Prevention and control of infections. 

(3) Interpersonal relationships and communication skills. 

(4) Fire prevention and safety. 

(5) Accident prevention and safety measures. 

(6) Confidentiality of patient inforination. 

(7) Preservation of patient's dignity, including provisions for privacy. 

(8) Patient's rights and patient's civil rights. 

(9) Signs and symptoms of cardiopulmonary distress. 

(10) Choking prevention and intervention. 

(b) In addition to (a) above, all licensed nurses shall have training in 
cardiopulmonary resuscitation. 

(c) Records of each staff development program shall be maintained. 
The records shall include name and title of presenter, date of presenta- 
tion, title of subject presented, description of content and the signatures 
of those attending. 

(d) Each Institute shall have a written orientation program for all new- 
ly hired employees. Each employee shall receive orientation to the Insti- 
tute, the employee's job description and duties, the patient population, 
the pertinent policies and procedures and the Institute staff. 

NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97322.9. Nurse Assistant Training and Certification. 

(a) Orientation and in-service education shall take place in the Skilled 
Nursing Services Unit or Intermediate Care Services Unit, or both, of the 
Institute. Each Institute shall have a written plan of the orientation and 
in-service education program approved by the Department which shall 
include objectives, course content and methods of teaching and evalua- 
tion of student learning. 

(b) Each Institute shall: 

(1 ) Designate a licensed nurse as director of nurse training whose only 
responsibility, during the hours specified, shall be management of the ap- 
proved nurse assistant training program. Other Institute staff may partici- 
pate when appropriate. 

(2) Submit to the Department for approval the name and a statement 
listing the professional qualifications of the director of nurse training and 
keep this information on file in the Institute. 

(3) Submit to the Department for approval the name and a statement 
listing the professional qualifications of the new director of nurse train- 
ing no later than 30 calendar days after replacement of the director. 



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§ 97322.9 



• 



(c) The director of nurse training shall have at least the following quali- 
fications: 

(1) One year of full-time experience as a licensed nurse in providing 
direct nursing care to aged persons or chronically ill persons. 

(2) One year of experience in planning, implementing and evaluating 
education programs in the field of nursing. If the director of nurse training 
does not possess this qualification requirement, one of the following shall 
apply: 

(A) Within 6 months of employment, the director shall receive a mini- 
mum of 10 hours of individualized, ongoing consultation in the Skilled 
Nursing Services Unit or Intermediate Care Services Unit of the Institute 
from a registered nurse who does possess this quahfication requirement. 
A written agreement shall be made between the Institute and the regis- 
tered nurse providing consultation and shall be kept on file in the Insti- 
tute. A record shall also be kept of the dates of consultation visits with 
content and recommendations noted. 

(B) Within 6 months of employment, the director shall obtain a mini- 
mum of 24 hours of continuing education in nursing education courses 
approved by the Board of Registered Nursing which are relevant to plan- 
ning, implementing and evaluating educational programs in the field of 
nursing. A record of class content and dates attending shall be kept on file 
in the Institute. 

(d) In Institutes in which only orientation and in-service education are 
provided, the director of nurse training shall be employed as follows: 

(1) Institutes designated for 100 or more skilled nursing or intermedi- 
ate care beds shall employ the director of nurse training in this capacity 
for at least 93 hours per month. 

(2) Institutes designated for 60-99 skilled nursing or intermediate care 
beds shall employ the director of nurse training in this capacity for at least 
54 hours per month. 

(3) Institutes designated for 59 or fewer skilled nursing or intermediate 
care beds shall employ the director of nurse training in this capacity for 
at least 26 hours per month. 

(e) In Institutes in which orientation, in-service education and a pre- 
certification training program are provided, the director of nurse training 
shall be employed as follows: 

(1) In Institutes designated for 100 or more skilled nursing or interme- 
diate care beds, the director of nurse training shall be employed in this 
capacity 40 hours a week for the total time required to provide the three 
components of the training program. 

(2) In Institutes designated for 60-99 skilled nursing or intermediate 
care beds, the director of nurse training shall be employed in this capacity 
for at least 30 hours a week for the total time required to provide the three 
components of the training program. 

(3) In Institutes designated for 59 or fewer skilled nursing or interme- 
diate care beds, the director of nurse training shall be employed in this 
capacity for at least 20 hours a week for the total time required to provide 
the three components of the training program. 

(f) Institutes electing to contract for the precertification training pro- 
gram shall employ a director of nurse training as stated in Section 
97322.9(e). 

(g) Orientation Program — Each nurse assistant shall receive 16 docu- 
mented hours of orientation which shall be completed during the first 40 
hours of employment. This orientation shall be conducted as follows: 

( 1 ) Prior to providing direct patient care and during the first eight hours 
of employment each nurse assistant shall be given: 

(A) A tour of the Skilled Nursing Services Unit or Intermediate Care 
Services Unit of the Institute, including: 

1. Description of patient population. 

2. Daily routine for patients. 

3. Use of equipment including nurse's call system and intercommuni- 
cation system. 

(B) Instruction in procedures to be followed in an emergency: 

1. Unusual occurrences with patients including but not limited to, 
emergency procedures for the relief of choking. 



2. Fire. 

3. Disaster. 

(C) Introduction to patient care with clinical practice supervised by the 
director of nurse training or another designated licensed nurse. 

(2) The remaining hours of the orientation program shall include, but 
not be limited to: 

(A) Administrative structure. 

(1) Organization of staff. 

(2) Services offered. 

(3) The role of nurse assistants, including job description, team con- 
cept, and attitudes and approaches to patients. 

(4) Personnel policies, including appearance and grooming. 

(B) The philosophy of patient care in the Skilled Nursing Services Unit 
or Intermediate Care Services Unit of the Institute. 

(C) Patient's rights. 

(D) Legal and ethical considerations of health care. 

(E) Nursing policies and procedures. 

(F) Patient comfort and environment. 

(G) The role of federal and state regulations in the provision of care 
by employees. 

(h) In-Service Education Program — Each Institute shall provide in- 
service education programs which shall be attended by nurse assistants 
assigned to all shifts. Each nurse assistant shall attend a minimum of 24 
documented hours of in-service education annually. The following shall 
be included in the annual planning for an in-service education program: 

(1) Content which builds on basic skills and theory acquired in the 
nurse assistant certification program and which shall include but not be 
limited to the following. 

(A) Working with patients who have special problems such as blind- 
ness, deafness, confusion or communication disabilities. 

(B) Bladder and bowel training and management. 

(C) Signs, symptoms and probable causes of patient distress with pro- 
cedures to be followed for alleviating distress, and emergency proce- 
dures for the rehef of choking. 

(D) Psychosocial aspects of aging and/or chronic illness as relevant to 
the individual, family and community with special emphasis on patients 
with Alzheimer's disease or related dementias. 

(E) Patient care elements including planning and organizing work 
while individualizing patient care; testing urine for sugar and acetone; 
measuring blood pressure; and administering nonmedicated enemas. 

(F) Nursing care relevant to body systems including, but not limited 
to fractures, diabetes, cardiac disorders, brain syndrome, cerebrovascu- 
lar accidents, arthritis, pulmonary disorders. 

(G) Nutritional needs of patients and related nursing interventions. 
(H) Oral hygiene. 

(1) Patient care conferences and patient care plans involving the patient 
and the patient's family, when appropriate. 

(J) Improving skills in observation, reporting, recording and maintain- 
ing confidentiality of patient information. 

(K) Developing effective relationships and means of intervention on 
behalf of the patients. 

(L) Activities program. 

(M) Working with the dying patient and the patient's family. 

(N) Environmental safety including fire and accident prevention. 

(O) Infection control. 

(P) Patient's rights and civil rights. 

(Q) Disaster preparedness. 

(R) Sensory deprivation and stimulation. 

(5) Maintenance of healthy skin: prevention of skin breakdown, body 
positioning and range of motion. 

(T) Use of adaptive equipment relevant to nutrition and physical dys- 
function. 

(2) Assessment of staff needs, program planning, implementation of 
plan and evaluation of staff learning. 

(i) Precertification Training Program. 



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(1) A precertification training program shall be conducted by the Insti- 
tute, agency or a public educational institution whose precertification 
training program meets the requirements of Section 97322. 9(i) and is ap- 
proved by the Department. For purposes of this section, agency means 
a private school, organization or individual who provides an approved 
preemployment training program or an approved precertification train- 
ing program for nurse assistants. 

(2) Approval of a precertification training program shall be based upon 
that program's ability to prepare nurse assistants for certification. 

(3) Each precertification training program shall be managed by the di- 
rector of nurse training in an Institute. 

(4) Credit for completed portions of an approved precertification train- 
ing program shall be transferable from one approved precertification 
training program to another upon submission of written proof of com- 
pleted portions. 

(5) After successful completion of an entire precertification training 
program, a nurse assistant shall receive a statement of completion from 
the course instructor to include at least the name of the approved pro- 
gram, program tide, the date the course was completed, the student, the 
student's name and signature of the instructor. 

(6) Registered nurses, dietitians, occupational therapists, physical 
therapists, physicians, social workers and other health professionals may 
be involved in appropriate aspects of the training program. 

(7) A licensed nurse shall be responsible for all segments of the precer- 
tification training program. 

(8) A licensed nurse may assist as clinical instructor to supervise stu- 
dents in clinical practice. 

(9) AppUcation shall be made by the Institute, agency or public educa- 
tional instiuition to the Department for approval of the precertification 
training program. The application shall contain the following: 

(A) Name, address and telephone number of the Institute, agency or 
educational institution offering the program. 

(B) Name and signature of the Institute administrator or the program 
administrator. 

(C) Name of Director of Nursing Services if applicable. 

(D) Name and professional qualifications of the director of nurse train- 
ing or licensed nurse responsible for the precertification training pro- 
gram. 

(E) Written plan of the precertification training program which shall 
include objectives, course content and hours, and methods of teaching 
and evaluation of student learning. 

(10) Approval of a precertification training program in an Institute, 
agency or a public educational institution shall be issued by the Depart- 
ment within 30 working days of the receipt of the application, upon veri- 
fication of compliance with the regulations for the precertification train- 
ing program. 

(1 1 ) No precertification training to be conducted by an Institute shall 
be approved unless the program meets the following: 

(A) The program shall be started within three months of employment 
of any uncertified nurse assistant in that Institute, and 

(B) The program shall be presented in its entirety and completed no 
later than six months from the date of employment of any uncertified 
nurse assistant in the program. 

(12) No precertification training program to be conducted by an Insti- 
tute shall be approved unless there is an initial enrollment of five or more 
uncertified nurse assistants currently employed by an Institute. 

(13) Each Institute having an approved precertification training pro- 
gram shall offer such program in its entirety a minimum of one time in 
each six-month period. 

(14) When an Institute makes arrangements for the provision of a pre- 
certification training program with an agency or public educational insti- 
tution, there shall be a written agreement outlining responsibilities for 
theory and supervision of clinical practice. The agreement shall be signed 
and dated by the Institute administrator and an authorized representative 
of the party presenting the precertification training program. 



(15) Each public educational institution having an approved precertifi- 
cation training program shall submit an application for renewal and its 
program for review upon request of the Department. 

(16) Each agency and Institute having an approved precertification 
program shall submit an application for renewal and its program to the 
Department for review at least annually as determined by the Depart- 
ment. 

(17) Failure to submit a precertification training program application 
for renewal of approval shall result in termination of approval. Reinstitu- 
tion of precertification training program approval may be granted no ear- 
lier than 90 calendar days from the prior approval expiration date. 

(18) An Institute, public educational institution or agency shall report 
in writing to the Department within 30 calendar days any changes in the 
approved precertification training program. 

( 19) A precertification training program shall consist of at least the fol- 
lowing: 

(A) One hundred (100) hours of cHnical practice under the direct su- 
pervision of the instructor or a licensed nurse which shall usually be con- 
ducted during normal working hours and which shall include demonstra- 
tions of theory and basic nursing skills. Return demonstrations by the 
student shall be under the immediate supervision of the instructor or a li- 
censed nurse. During clinical practice there shall be no more than 15 stu- 
dents to each instructor at any time. Clinical practice shall take place in 
the Skilled Nursing Care Services Unit or Intermediate Care Services 
Unit of the Institute and shall be conducted concurrently with classroom 
instruction. 

(B) Fifty (50) hours of classroom instruction which may be conducted 
in the Skilled Nursing Care Services Unit or Intermediate Care Services 
Unit of the Institute, or in an educational institution and shall consist of 
at least the following content and for the duration of hours specified. 

1. Role and responsibilities as a health team member (eight hours): 

a. Introduction. 

(i) Course objectives. 

(ii) Function and responsibility of the nurse assistant, 
(iii) Nursing policies and procedures, 
(iv) Legal aspects relevant to long-term care, 
(v) Ethics and confidentiality. 

(vi) Philosophy of long-term care in relation to geriatrics and chronic 
illness. 

(vii) Patient care plans. 

b. Understanding own needs, 
(i) Awareness of self. 

(ii) Effect of self on others. 

c. Cooperative role with health team members in data collection and 
patient care planning. 

d. Principles of observation and assessment of patients. 

e. Processes and techniques of communication. 

f. Reporting and documentation. 

g. Role of the nurse assistant in activity program needs of patients. 

2. Principles of safety and infection control (four hours). 

a. Body mechanics. 

b. Patient positioning, transferring and alignment, including utiliza- 
tion of footboard, bed cradle, overhead frame, hoyer lift, wheelstretcher 
and special mattresses. 

c. Patient safety; side rails, restraints, wheelchairs and ambulation de- 
vices. 

d. Infection control, 
(i) Handwashing, 
(ii) Linen handling. 

(iii) Transmission and prevention of infection, 
(iv) Cleaning of equipment such as thermometers, bedpans, urinals 
and enema equipment. 

3. Patient care skills (28 hours). 

a. Communication with patients. 

b. Personal hygiene and comfort measures. 



Page 1286 



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§ 97322.13 



• 



(i) Bathing; shower, tub bath, bed bath, shampoo, 
(ii) Dressing and undressing, 
(iii) Oral hygiene including denture care. 

(iv) Care of hearing aids, eyeglasses, prosthetic devices and personal 
equipment and belongings. 

(v) Bed making: occupied and unoccupied. 

(vi) Care of the incontinent patient. 

(vii) Skin care. 

(aa) Routine skin care. 

(bb) Prevention of decubitus ulcers. 

(cc) Perineal care. 

(viii) Care of the patient with a urinary catheter. 

c. Treatments and procedures. 

(i) Vital signs; temperature (oral, axillary, rectal), pulse, respiration. 

(ii) Weight and height. 

(iii) Intake-outputs; measuring, estimating, recording. 

(iv) Use of bedpans, urinal, commode. 

(v) Specimen collection; urine, stool, sputum. 

(vi) Application of clean dry dressing and bandages. 

(vii) Introduction to bowel and bladder management. 

d. Rehabilitation, 
(i) Ambulation. 

(ii) Range of motion. 

(iii) Remotivation. 

(iv) Activities of daily living. 

e. Physical needs of patients including basic anatomy and physiology. 

f. Nutrition. 

(i) Four basic food groups and fluids. 

(ii) Diets: regular, therapeutic and mechanically altered. 

(iii) Cultural and religious customs. 

(iv) Techniques of patient feeding and prevention of choking. 

4. Emotional, social and spiritual needs of patients (10 hours). 

a. Psychosocial needs. 

b. Understanding behavior and principles of intervention. 

c. Role changes. 

d. Socialization needs. 

e. Patient's rights. 

f. Maintaining and regaining optimum level of health. 

g. Spiritual needs of patient and family, 
h. Dealing with dying patients and death. 

(j) A nurse assistant shall be certified by the Department if the nurse 
assistant has satisfactorily completed an approved precertification train- 
ing program as specified in Section 97322.9. The course instructor shall 
notify the Department in writing no later than 10 working days after the 
completion of each precertification training program of the names, cur- 
rent address and Social Security numbers of those nurse assistants who 
successfully completed the program. The notification shall include the 
dates on which the course began and ended and the signature of the 
course instructor. The Department shall then issue the certificate to those 
nurse assistants. 

(k) The certificate issued pursuant to this section shall be valid for life 
and need not be renewed. 

(1) The Department may revoke the certificate of a nurse assistant con- 
victed of a crime which the Department determines is substantially re- 
lated to the practice of a nurse assistant, including any such conviction 
based upon a plea of nolo contendre. Additionally, the Department may 
revoke the certificate of a nurse assistant upon a finding of gross in- 
competence or gross negligence. 

(m) All Institutes shall maintain compUance with Section 97322.9. 
These requirements shall not prohibit the use of alternate concepts, meth- 
ods, procedures, techniques or personnel quaUfications in the provision 
of nurse assistant training programs provided such exceptions are carried 
out without reduction in the quality of nurse assistant training, the quality 
of patient care in the Institute or the ability of the precertification training 



program to prepare nurse assistants for certification. Such exceptions 
may only be carried out with the prior written approval of the Department 
which shall provide for the terms and conditions under which the excep- 
tion is granted. A written request and substantiating evidence supporting 
the request shall be submitted by the applicant or licensee to the Depart- 
ment. 

(n) A copy of any exception approved granted by the Department un- 
der Section 97322. 9(m) shall be maintained in the Institute by the admin- 
istrator and shall be available to all personnel. 

NOTE: Authority cited: Sections 13 11 .5 and 1 3 12.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and;is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97322.1 1 . Employee Personnel Records. 

(a) Each Institute shall maintain current, complete and accurate per- 
sonnel records for all employees. 

(1) The record shall include: 

(A) Full name. 

(B) Social Security number. 

(C) Professional license or registration number, if applicable. 

(D) Employment classification. 

(E) Information as to past employment and qualifications. 

(F) Date of beginning of employment. 

(G) Date of termination of employment. 

(H) Documentation of orientation to the Institute. 

(1) Performance evaluations. All employees shall be evaluated on at 
least a yearly basis. 

(2) Such records shall be retained for at least three years following ter- 
mination of employment. Employee personnel records shall be main- 
tained in a confidential manner, and shall be made available to authorized 
representatives of the Department or Office upon request. 

(b) Records of hours and dates worked by all employees during at least 
the most recent 12-month period shall be kept on file at the place of em- 
ployment or at a central location within the State of California. Upon re- 
quest such records shall be made available, at a time and location speci- 
fied by the Department. 

(c) A permanent log of the temporary health services personnel 
employed in the Institute shall be kept for three years, and shall include 
the following: 

(1) Employee's full name. 

(2) Name of temporary health services personnel agency. 

(3) Professional license and registration number and date of expira- 
tion, if applicable. 

(4) Verification of health status. 

(5) Record of hours and dates worked. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code 

72533. Reference: Section 1311. 5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97322.13. Employees' Health Examination and Health 
Records. 

(a) All employees working in the Institute, including the administra- 
tor, shall have a health examination within 90 days prior to employment 
or within seven days after employment and at least annually thereafter by 
a person lawfully authorized to perform such a procedure. Each such ex- 
amination shall include a medical history and physical evaluation. The 
report signed by the examiner shall indicate that the person is sufficiently 
free of disease to perform assigned duties and does not have any health 
condition that would create a hazard for that person, fellow employees, 
patients or visitors. 



Page 1287 



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(b) The initial health examination and subsequent annual examination 
shall include a purified protein derivative intermediate strength introder- 
mal skin test for tuberculosis. A chest X-ray is indicated if the employee 
has previously had a positive reaction to a tuberculosis skin test or is cur- 
rendy being treated for tuberculosis. Positive reaction to the skin test 
shall be followed by a 35.56 cm x 43. 1 8 cm (14" x 1 7" ) chest X-ray . Evi- 
dence of tuberculosis screening within 90 days prior to employment shall 
be considered as meeting the intent of this Section. 

(c) The Institute shall maintain a health record of the administrator and 
for each employee which includes reports of all employment-related 
health examinations. Such records shall be kept for a minimum of three 
years following termination of employment. 

NOTE; Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 13 11. 5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97322.15. Governance. 

Each Institute shall be governed by a governing body which shall be 
the governing body of a licensed general acute hospital, as defined in sub- 
division (a) of Section 1250 of the Health and Safety Code. 
NOTE: Authority cited: Sections 13 11. 5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 13 11. 7, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 

was adopted on an interim basis as authorized by Health and Safety Code Sec- 

fion 1312.7 and is repealed by operation of that same section effective 7-1-90 

(Register 87, No. 15). 



Article 4. Environmental Safety and Health 

§ 97323.1 . Multiple Buildings. 

All sections in this article shall apply to each building, physical plant 
or other separate unit maintained by the Institute for patient care. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 13 11. 5, Health and Safety Code. 

History 
1 . New section filed 4—6-87 as an emergency; effective upon fihng. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
don 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97323.3. Fire Safety. 

The designee shall conform to the regulations adopted by the State Fire 
Marshal establishing minimum standards for the prevention of fire and 
for the protection of life and property against fire and panic. A copy of 
the State Fire Marshal's current fire clearance shall be available at the In- 
stitute. 

Note: Authority cited: Secfions 13 1 1 .5 and 131 2.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 
1. New secfion filed 4—6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97323.5. Fire and Internal Disasters. 

(a) A written fire and internal disaster plan incorporating evacuation 
procedures shall be developed with the assistance of qualified fire, safety 
and other appropriate experts. A copy of the plan shall be available on the 
premises for review by the staff and the Department. 

(b) The written plan shall include at least the following: 

(1) Procedures for the assignment of personnel to specific tasks and 
responsibilities. 

(2) Procedures for the use of alarm systems and signals. 

(3) Procedures for fire containment. 

(4) Priority for notification of staff including names and telephone 
numbers. 



(5) Location of fire-fighting equipment. 

(6) An evacuation plan which shall contain procedures for evacuation 
and specification of evacuation routes. 

(7) Procedures for moving patients from damaged areas of the Institute 
to undamaged areas. 

(8) Procedures for emergency transfer of patients who can be moved 
to other health facilities, including arrangements for safe and efficient 
transportation. 

(9) Procedures for emergency discharge of patients who can be dis- 
charged without jeopardy into the community, including prior arrange- 
ments for their care, arrangements for safe and efficient transportation 
and at least one follow-up inquiry within 24 hours to ascertain that pa- 
tients are receiving their required care. 

(1 0) A disaster tag containing all pertinent personal and medical infor- 
mation to accompany each patient who is moved, transferred, discharged 
or evacuated. 

(1 1 ) Procedures for maintaining a record of patient relocation. 

(12) Procedures for handling incoming or relocated patients. 

(13) Other provisions as dictated by circumstances. 

(c) Fire and internal disaster drills shall be held at least quarterly, under 
varied conditions for each individual shift of the Institute personnel. The 
actual evacuation of patients to safe areas during a drill is optional. 

(d) The evacuation plan shall be posted throughout the Institute and 
shall include at least the following: 

(1) Evacuation routes. 

(2) Location of fire alarm boxes. 

(3) Location of fire extinguishers. 

(4) Emergency telephone number of the local fire department. 

(e) A dated, written report and evaluation of each drill and rehearsal 
shall be maintained and shall include signatures of all employees who 
participated. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 

1. New section filed 4—6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97323.7. Smoking. 

(a) Patients shall not be permitted to smoke in or on the bed except 
when an Institute staff member or other responsible adult is present in the 
room to ensure safety against fire hazards. 

(b) The Institute shall provide designated areas for smoking. Patients 
shall be permitted to smoke only in designated areas. The designated area 
shall be under the periodic observation of Institute personnel or responsi- 
ble adults. This does not preclude the designadon of the patients' rooms 
as smoking areas. 

(c) The Institute shall provide a designated area for nonsmoking pa- 
tients. Such a designated area shall be identified by prominently posted 
"No Smoking" signs. 

(d) Smoking or open flames shall not be permitted in any rooms or 
spaces where oxygen cylinders are stored or where oxygen is in use. Such 
rooms or spaces shall be identified by prominently posted "No Smoking" 
or "No Open Flame" signs. 

(e) The Institute shall make every reasonable effort to assign patients 
to rooms according to the patient's individual nonsmoking or smoking 
preferences. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effecrive 7-1-90 
(Register 87, No. 15). 

§ 97323.9. External Disaster and Mass Casualty Program. 

(a) A written external disaster and mass casualty program plan shall 
be adopted and followed. The plan shall be developed with the advice and 



Page 1288 



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Health Planning and Facility Construction 



§ 97324.5 



assistance of county or regional and local disaster planning authority and 
shall not conflict with county and community disaster plans. A copy of 
the plan shall be available on the premises for review by the Department. 

(b) The plan shall provide procedures in event of community and 
widespread disasters. The written plan shall include at least the follow- 
ing: 

(1) Sources of emergency utilities and supplies, including gas, water, 
food and essential medical supportive materials. 

(2) Procedures for assigning personnel and recalling off-duty person- 
nel. 

(3) Unified medical command. A chart of lines of authority in the Insti- 
tute. 

(4) Procedures for the conversion of all usable space into areas for pa- 
tient observation and immediate care of emergency admissions. 

(5) Procedures for prompt transfer of casualties when necessary and 
after preliminary medical or surgical services have been rendered, to the 
facility most appropriate for administering definitive care. Procedures 
for moving patients from damaged areas of the facility to undamaged 
areas. 

(6) Arrangements for provision of transportation of patients including 
emergency housing where indicated. Procedures for emergency transfer 
of patients who can be moved to other health facihties, including arrange- 
ments for safe and efficient transportation and transfer information. 

(7) Procedures for emergency discharge of patients who can be dis- 
charged without Jeopardy into the community, including prior arrange- 
ments for their care, arrangements for safe and efficient transporta- 
tion$and at least one follow-up inquiry within 24 hours to ascertain that 
patients are receiving required care. 

(8) Procedures for maintaining a record of patient relocation. 

(9) An evacuation plan, including evacuation routes, emergency 
phone numbers of physicians, health facilities, the fire department and 
local emergency medical services agencies and arrangements for the safe 
transfer of patients after evacuation. 

(10) A tag containing all pertinent personal and medical information 
which shall accompany each patient who is moved, transferred, dis- 
charged or evacuated. 

(11) Procedures for maintaining security in order to keep relatives, vis- 
itors and curious persons out of the Institute during a disaster. 

(12) Procedures for providing emergency care to incoming patients 
from other health facilities. 

(13) Assignment of public relations liaison duties to a responsible indi- 
vidual employed by the Institute to release information to the pubUc dur- 
ing a disaster. 

(c) The plan shall be reviewed at least annually and revised as neces- 
sary to ensure that the plan is current. All personnel shall be instnicted 
in the requirements of the plan. There shall be evidence in the personnel 
files, or the orientation checklist, indicating that all new employees have 
been oriented to the plan and procedures at the beginning of their employ- 
ment. 

(d) The Institute shall participate in all local and state disaster drills and 
test exercises when asked to do so by the local or state disaster or emer- 
gency medical services agencies. 

(e) A disaster drill shall be held by the Institute at six-month intervals. 
These shall be a written report of the Institute' s participation in each drill 
or test exercise and shall include signatures of all employees who partici- 
pated. Staff from all shifts shall participate in drills or test exercises. 
NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 13 11. 5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15), 

§ 97323.1 1 . Reporting of Communicable Diseases. 

All cases of reportable communicable diseases shall be reported to the 
local health officer in accordance with Section 2500, Part 1 , Chapter 4, 
Subchapter 1 , Article 1 of Title 1 7 ofthe California Administrafive Code. 



NOTE: Authority cited: Sections 1311 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon fihng. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 1 5). 

§ 97323.1 3. Reporting of Outbreaks. 

Any outbreak or undue prevalence of infectious or parasitic disease or 
infestation shall be reported to the local health officer in accordance with 
Section 2502, Part 1 , Chapter 4, Subchapter 1 , Article 1 of Title 1 7 ofthe 
California Administrafive Code. 

NOTE; Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 13 11. 5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Regi.ster 87, No. 15). 

§97323.15. Unusual Occurrences. 

Occurrences such as epidemic outbreaks, poisonings, fires, major ac- 
cidents or death from unnatural causes, or other catastrophes and unusual 
occurrences which threaten the welfare, safety or health of patients, per- 
sonnel or visitors, shall be reported by the Insfitute within 24 hours either 
by telephone (and confirmed in wrifing) or by telegraph to the local 
health officer, the Department and the Office. An incident report shall be 
retained on file by the Institute for one year. The Institute shall furnish 
such other pertinent information related to such occurrences as the local 
health officer or the Department may require. Every fire or explosion 
which occurs in or on the premises shall be reported within 24 hours to 
the local fire authority or, in areas not having an organized fire service, 
to the State Fire Marshal. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 

was adopted on an interim basis as authorized by Health and Safety Code Sec- 

fion 1312.7 and is repealed by operation of that same section effective 7-1-90 

(Register 87, No. 15). 



Article 5. Physical Plant 

§97324.1. Distinct Part. 

The Insfitute shall provide a distinct part area or areas for each type of 
services specified in Sub-chapters 3 through 13 that the Insfitute directly 
provides. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and ] 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.3. Multiple Buildings. 

All sections in this article shall apply to each building, physical plant 
or other separate unit maintained by the Institute for patient care. 
NOTE: Authority cited: Sections 131 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.5. Application for Plan Review. 

(a) Drawings and specifications for alterations to existing buildings or 
new construction prepared as required by Article 3 of Chapter 7 of Divi- 
sion 7 of Titie 22 of the California Administrative Code (commencing 
with Section 94037), shall be submitted to the Office for approval and 
shall be accompanied by an application for plan review on forms fur- 



Page 1289 



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Title 22 



nished by the Office. The appHcalion shall be accompanied by the fee re- 
quired by Section 94056 of Title 22. The application shall: 

(1) Identify and describe the work to be covered by the plan review for 
which the application is made. 

(2) Describe the land on which the proposed work is to be done, by lot, 
block, tract or house and street address or similar description that will 
readily identify and definitely locate the proposed building or work. 

(3) Show the present and proposed use or occupancy of all parts of the 
building or buildings. 

(4) State the number of square feet of floor area involved in new con- 
struction and in alterations. 

(5) Give such other information as may be required by the Office. 

(6) Be signed by the person designing the work or the owner of the 
work. 

NOTE: Authority cited: Sections 1 3 11 .5 and ] 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.7. Space Conversion. 

Spaces approved for specific uses at the time of designation shall not 
be converted to other uses without the approval of the Office. 
Note. Authority cited: Sections 1 3 1 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Secfion 131 1.5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.9. Notice to Office. 

The Office shall be notified, in writing, by the owner, or designee, of 

the Institute, prior to the commencement of any approved construction, 

remodeling or alterations to such Institute. 

NOTE: Authority cited: Sections 1311. 5 and 1312.7,HealthandSafety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.1 1 . Patient Capacity. 

(a) An Institute shall not have more patients or beds set up for use than 
the number for which it is designated as shown on the Designation Certif- 
icate, except in cases of emergency when temporary permission may be 
granted by the Director. 

(b) Patients shall not be housed in areas which have not been approved 
by the Department for patient housing and which have not been given a 
fire clearance by the State Fire Marshal except as provided in paragraph 
(a) above. 

(c) The number of beds shown on a Designation Certificate shall not 
exceed the number of beds for which the Institute meets applicable con- 
struction and operational requirements. 

(d) Five percent of the designated beds in an Institute may be used for 
a classification other than that designated. Upon application to the Direc- 
tor of the Department and a showing that seasonal fluctuations justify , the 
Director of the Department may grant the use of an additional five per- 
cent of the beds for other than the designated use. 

(e) In the event that a vacant licensed bed is not available for training 
purposes, facilities with approved precertification training programs 
may request approval from the appropriate district office of the Depart- 
ment for the designation of a certain bed for clinical practice which would 
not be included as a bed licensed for the use of patients. The following 
criteria must be met in order to obtain approval: 

(1) The bed is to be designated and utilized for training purposes only. 



(2) The bed is to be located in nonpatient sleeping areas, e.g., clas- 
sroom, examining room, etc. The location of the bed is to be indicated. 

(3) The bed shall not be equipped with linen except during staff train- 
ing hours. 

(4) Under no circumstances is a patient to be assigned to the bed desig- 
nated for training purposes. 

(5) The approval of a bed for training purposes only shall be contingent 
upon the approval of the Institute's precertification training program. If 
the Institute discontinues its precertification training program, the ap- 
proval for use of the bed for training purposes is automatically cancelled. 
NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.13. Patient Rooms. 

(a) Each patient' s room shall be labeled with a number, letter or combi- 
nation of the two for identification. 

(b) Patient's rooms shall not be kept locked when occupied except as 
approved by the Department. 

(c) Only upon the written approval of the Department may any exit 
door, corridor door, yard enclosures or perimeter fences be locked to 
egress. 

(d) Each patient shall be provided clean, comfortable and reasonably 
private living accommodations with no more than four patients occupy- 
ing a room. 

(e) Patients shall be accommodated only in rooms approved by the Of- 
fice with the following minimum floor area: 

(1) Single room: 1 10 square feet 

(2) Multibed rooms: 80 square feet per bed 

(f) Patient's rooms approved for use by ambulatory patients only shall 
be identified as follows: The words "Reserved for Ambulatory Patient" 
in letters at least one-half inch high shall be posted on the outside of the 
door or on the wall alongside the door where they are visable to persons 
entering the room. 

NOTE: Authority cited: Sections 13 1 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97324.15. Special Rooms. 

Special rooms shall be maintained as required by Sections 2-1015A(f) 
and 2-1004B of Title 24 of the California Adininistrative Code. 

NOTE: Authority cited: Sections 1311.5, 1312.7 and 18944, Health and Safety 

Code. Reference: Section 131 1 .5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97324.17. Patient's Property Storage and Room 
Furnishings. 

(a) Each patient room shall be provided with a closet or locker space 
for clothing, toilet articles and other personal belongings. 

(b) For each licensed bed there shall be provided: 

(1) A clean comfortable bed with an adequate mattress, sheets, pillow, 
pillow case and blankets, all of which shall be in good repair, and consis- 
tent with individual patient needs. 

(2) A bedside table, chair, overbed table and reading light all of which 
shall be in good repair. 

NotE: Authority cited: Sections 131 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Secfion 131 1.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 



Page 1290 



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Health Planning and Facility Construction 



§ 97324.29 



tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.19. Provision for Privacy. 

Visual privacy for each patient shall be provided as required by Sec- 
tion 2-1015 A(j) of Title 24 of the California Administrative Code. Doors 
providing access to the corridor shall not be considered as meeting this 
requirement. 

NOTE; Authority cited: Sections 1311.5, 1312.7 and 18944, Health and Safety 

Code. Reference: Section 1311.5, Health and Safety Code. 

History 

1 . New section filed 4—6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.21 . Public Telephone. 

(a) A public telephone shall be installed on each floor accommodating 
patients. This may not be required in separate buildings having six beds 
or less which are restricted to occupancy by ambulatory patients. 

(b) The telephone at the nurses' station shall not be considered as meet- 
ing the requirements of this section. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 
] . New section fded 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.23. Space and Equipment for Autoclaving, 
Sterilizing and Disinfecting. 

(a) The Institute shall: 

(1) Maintain disposable sterile supplies in the amount necessary to 
meet the anticipated needs of the patients, or 

(2) Maintain autoclave equipment, or 

(3) Make contractual arrangements for outside autoclaving and steril- 
izing services. 

(b) If an Institute maintains a central supply and sterilizing area, it shall 
include but not be limited to: 

(1) An autoclave or sterilizer, which shall be maintained in operating 
condition at all times. 

(A) Autoclaves shall be equipped with time recording thermometers 
in addition to the standard mercury thermometers, except for portable 
sterilizers and autoclaves. 

(B) Instructions for operating autoclaves and sterilizers shall be posted 
in the area where the autoclaves and sterilizers are located. 

(2) Work space. 

(3) Storage space for sterile supphes. 

(4) Storage space for unsterile supplies. 

(5) Equipment for cleaning and sterilizing of utensils and supplies. 

(c) The Institute shall provide for: 

(1) Effective separation of soiled and contaminated supplies and 
equipment from the clean and sterilized supplies and equipment. 

(2) Clean cabinets for the storage of sterile supplies and equipment. 

(3) An orderly system of rotating of supplies so that the supplies stored 
first shall be used first and that multi-use supplies shall be reautoclaved 
as they become outdated. 

(4) Dating of materials sterilized. 

(5) Loading of the autoclave or sterilizer. 

(6) Checking of recording and indicating thermometers. Recording 
thermometer charts shall be on file for one year. 

(7) Conducting monthly bacteriological tests. Reports of test results 
for the last 12 months shall be retained on file. 

(8) Length of aeration time for materials that are gas-sterilized. 
NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence; Section 131 1.5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 



tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97324.25. Housekeeping. 

(a) Each Institute shall routinely clean articles and surfaces such as fur- 
niture, floors, walls, ceihngs, supply and exhaust grills and h'ghting fix- 
tures. 

(b) Schedules and procedures shall be posted which indicate the areas 
of the Institute which shall be cleaned daily, weekly or monthly. The 
cleaning schedules and procedures shall be implemented. 

(c) Cleaning supplies and equipment shall be available to housekeep- 
ing staff. Such cleaning supplies and equipment shall meet the following 
requirements. 

(1) Cleaning supplies and equipment shall be stored in rooms for 
housekeeping use only. 

(2) A commercial detergent germicide shall be used for all cleaning. 

(3) Mop heads shall be removable and changed at least daily. 

(d) Housekeeping personnel shall be employed to maintain the interior 
of the Institute in a safe, clean, orderly and attractive manner free from 
offensive odors. 

(e) A person qualified by experience and training shall be in charge of 
the housekeeping department. 

(0 Janitor's closets, service sinks and storage areas shall be clean and 
maintained to meet the needs of the Institute. 

NOTE; Authority cited: Sections 1311 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon fihng. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effecfive 7-1-90 
(Register 87, No. 15). 

§ 97324.27. Laundry. 

(a) When an Institute operates its own laundry, such laundry shall be: 

(1 ) Located in relationship to other areas so that steam, odors, lint and 
objectionable noises do not reach patient or personnel areas. 

(2) Adequate in size, well-lighted and ventilated to meet the needs of 
the Institute. 

(3) Laundry equipment shall be of a suitable capacity, kept in good re- 
pair and maintained in a sanitary condition. 

(4) The laundry space shall be maintained in a clean and sanitary con- 
dition. 

(b) If the Institute does not maintain a laundry service, the commercial 
laundry utilized shall meet the standards of this section. 

(c) Laundry areas shall have, at a minimum, the following: 

(1) Separate rooms for the storage of clean linen and soiled linen. 

(2) Handwashing and toilet facilities maintained at locations conve- 
nient for laundry personnel. 

(3) Separate linen carts labeled "soiled" or "clean linen" and con- 
structed of washable materials which shall be laundered or suitably 
cleaned as needed to maintain sanitation. 

(d) Written procedures for handling, storage, transportation and pro- 
cessing of linens shall be posted in the laundry and shall be implemented. 
Note; Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.29. Clean Linen. 

(a) Clean linen shall be stored, handled and transported in a way that 
precludes cross-contamination. 

(b) Clean linen shall be stored in clean, ventilated closets, rooms or al- 
coves, used only for that purpose. 

(c) Clean linen not in covered storage shall be covered. 

(d) Clean linen from a commercial laundry shall be delivered to a des- 
ignated clean area in a manner that prevents contamination. 



Page 1291 



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BARCLAYS CALIFORNIA CODE OF REGULATIONS 



Title 22 



(e) Linen shall not be threadbare and shall be maintained in good re- 
pair. 

(f) A supply of linen shall be provided sufficient for not less than three 
complete bed changes for the Institute's designated capacity. 

(g) A supply of clean wash cloths and towels shall be provided and 
available to staff to meet the care needs of the patients. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 31 2.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15) 

§97324.31. Soiled Linen. 

(a) Soiled Hnen shall be handled, stored and processed in a manner that 
will prevent the spread of infection. 

(b) Soiled linen shall be sorted in a separate room by methods afford- 
ing protection from contamination. 

(c) Soiled linen shall be stored and transported in a closed container 
which does not permit airborne contamination of corridors and areas oc- 
cupied by patients and precludes cross contamination of clean linen. 

(d) When laundry chutes are used to transport soiled linen, they shall 
be maintained in a clean, sanitary state. 

NOTE: Authority cited: Sections 1311.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.33. Provisions for Emptying Bedpans. 

Bedpans shall be emptied and cleaned in utility rooms unless toilets 
adjoining patients' rooms are equipped with flushing attachments and 
vacuum breakers. Bathtubs, lavatories or laundry sinks shall not be used 
for cleaning and emptying bedpans. 

NOTE: Authority cited: Sections 1311 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97324.35. Signal Systems. 

(a) A nurses' signal system shall be maintained in operating order as 
required by Section 3-517-123, Part 3 of Title 24 of the California Ad- 
ministrative Code. 

(b) Nurses' call systems shall be maintained in a manner that will pro- 
vide viable and audible signal communicadon between nursing person- 
nel and all inpatient rooms. The minimum requirements are: 

(1) A call station or stations providing detachable extension cords to 
each patient's bed in the padent's room. These extension cords shall be 
readily accessible to patients at all dmes unless the attending physician 
decides otherwise. 

(2) A visible signal in the corridor above the corridor door of each pa- 
tient' s bedroom visible from all parts of the corridor. 

(3) An audible signal and a nurses' call annunciator indicating the 
room from which the call originates or an alternate system approved in 
writing by the Department, shall be located at the nurse's station. The 
sounding of the audible signal shall be continuous or intermittent undl 
answered. 

(c) A nurses' caJJ system shall be provided in each padent's toilet 
room, bathroom, and shower room in locations easily accessible to the 
patients. Electric shock hazard shall be eliminated by grounding or by an 
equally effective method. 

(d) The nurses' call system shall be so designed as to require resetdng 
at the station where the call originates unless a two-way voice communi- 
cadon component is included in the system. 



(e) A nurses' call system shall be installed in all services units where 

there are inpatients and in the toilets, bathrooms, and shower rooms of 

services units serving outpadents of the Institute. 

NOTE: Authority cited: Secfions 1311.5, 1312.7 and 18944, Health and Safety 

Code. Reference: Section 1 31 1 .5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operafion of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§ 97324.37. Utility Rooms. 

Utility rooms shall be maintained as required by Secdon 2-1015A(i), 
Part 2 of Title 24 of the California Administradve Code. 
NOTE: Authority cited: Secfions 1311.5, 1312.7 and 18944, Health and Safety 
Code. Reference: Secfion 131 1 .5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.39. Handrails. 

Corridors shall be equipped with firmly secured handrails as required 
by Secdon 2-1005 A(d), Part 2 of Tide 24 of the California Administra- 
dve Code. 

NOTE; Authority cited: Sections 1311.5, 1312.7 and 18944, Health and Safety 
Code. Reference: Section 1311.5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§97324.41. General Maintenance. 

(a) The Institute, including the grounds, shall be maintained in a clean 
and sanitary condidon and in good repair at all dmes to ensure safety and 
well-being of patients, staff and visitors. 

(b) Buildings and grounds shall be free of environmental pollutants 
and such nuisances as may adversely affect the health or welfare of pa- 
dents to the extent that such condidons are within the reasonable control 
of the Insdtute. 

(c) All buildings, fixtures, equipment and spaces shall be maintained 
in operable condition. 

(d) Personnel shall be employed to provide prevendve maintenance 
and to carry out the required maintenance program. 

(e) Equipment provided shall meet all applicable California Occupa- 
donal Safety and Health Act requirements in effect at the time of pur- 
chase. All portable electrical medical equipment designed for 110-120 
volts, 60 hertz current, shall be equipped with a three wire grounded pow- 
er cord with a hospital grade three prong plug. The cord shall be an inte- 
gral part of the plug. 

(f) The Insdtute shall be maintained free from vermin and rodents 
through operation of a pest control program. The pest control program 
shall be conducted in the main patient buildings, all outbuildings on the 
property and all grounds. 

NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 1311.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§97324.43, Air Filters. 

(a) The designee shall be responsible for regular inspecdon, cleaning 
or replacement of all filters installed in heating, air condidoning and ven- 
tilating systems, as necessary to maintain the systems in normal operat- 
ing condidon. 

(b) A written record of inspecdon, cleaning or replacement, including 
static pressure drop, shall be maintained and available for inspecdon. The 
record shall include a description of the filters originally installed, the 



Page 1292 



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Health Planning and Facility Construction 



§ 97324.53 



American Society of Heating, Refrigeration and Air Conditioning Engi- 
neers (ASHRAE) efficiency rating and the criteria established by the 
manufacturer or supplier to determine when replacement or cleaning is 
necessary. 

(c) Following filter replacement or cleaning, the installation shall be 
visually inspected for torn media and by-pass in filter frames by means 
of a flashlight or equivalent, both with fans in operation and stopped. 
Tears in filter media and by-pass in filter frames shall be eliminated in 
accordance with the manufacturer's directions and as required by the De- 
partment. 

(d) Where a filter maintenance is performed by an equipment service 
company, a certification shall be provided to the designee that the re- 
quirements listed in this section have been accommodated. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secvion 1311.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.45. Emergency Lighting and Power System. 

(a) Auxiliary lighting and power facilities shall be provided as re- 
quired by Articles 3-517 and 3-700, Part 3 of Title 24 of the California 
Administrative Code. Flashlights shall be in readiness for use at all times. 
Open-flame type of hght shall not be used. 

(b) The designee shall provide and maintain an emergency electrical 
system in safe and operating condition and in compliance with subsec- 
tions (d), (e), and (f). The system shall serve all lighting, signals, alarms 
and equipment required to permit continued operation of all necessary 
functions of the facility for a minimum of six hours. 

(c) If the Department determines that an evaluation of the emergency 
electrical system of a facility or portion thereof, is necessary, the Depart- 
ment may require the designee to submit a report by a registered electrical 
engineer which shall establish a basis for alteration of the system to pro- 
vide reasonable compliance with Articles 3-517 and 3-700, Part 3 of 
Title 24 of the California Administrative Code. Essential engineering 
data, including load calculations, assumptions and tests, and where nec- 
essary, plans and specifications, acceptable to the Department, shall be 
submitted in substantiation of the report. When corrective action is deter- 
mined to be necessary, the work shall be initiated and completed within 
an acceptable time limit. 

(d) The emergency lighting and power system shall be maintained in 
operating condition to provide automatic restoration of power for emer- 
gency circuits within ten seconds after normal power failure. 

(e) Emergency generators shall be tested at least every 14 days under 
full load condition for a minimum of 30 minutes. 

(f) A written record of inspection, performance, exercising period and 
repair of the emergency electrical system shall be regularly maintained 
on the premises and available for inspection by the Department. 
NOTE: Authority cited: Sections 1311.5, 1312.7 and 18944, Health and Safety 
Code. Reference: Section 1311.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.47. Storage and Disposal of Solid Wastes. 

(a) Solid wastes shall be stored and eliminated in a manner to preclude 
the transmission of communicable disease. These wastes shall not be a 
nuisance or a breeding place for insects or rodents nor be a food source 
for either. 

(b) Solid waste containers shall be stored and located in a manner that 
will minimize odors in patient or dietary areas. 

(c) Syringes and needles, before being discarded into waste contain- 
ers, shall be rendered unusable. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 



History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.49. Solid Waste Containers. 

(a) All containers, except movable bins used for storage of solid 
wastes, shall have tight-fitting covers in good repair, external handles 
and be leakproof and rodent proof. 

(b) Movable bins, when used for storing or transporting solid wastes 
from the premises, shall have approval of the local health department and 
shall meet the following requirements: 

(1) Have tight-fitting covers, closed when not being loaded. 

(2) Be in good repair. 

(3) Be leakproof. 

(4) Be rodent proof unless stored in a room or screened enclosure. 

(c) All containers receiving putrescrible wastes shall be emptied at 
least every four days or more if necessary. 

(d) Solid waste containers, including movable bins, shall be thorough- 
ly washed and cleaned each time they are emptied unless soil contact sur- 
faces have been completely protected from contamination by disposable 
liners, bags or other devices removed with the waste. Each movable bin 
shall be accessible and shall have a drainage device to allow complete 
cleaning at the storage area. 

NOTE: Authority cited: Sections 1 3 1 1 .5 and 1 3 12.7, Health and Safety Code. Ref- 
erence: Section 13 11. 5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.51 . Infectious Waste. 

Infectious waste, as defined in Health and Safety Code Section 
25T17.5, shall be handled and disposed of in accordance with the Hazard- 
ous Waste Control Law, Chapter 6.5, Division 20, Health and Safety 
Code (beginning with Section 25100) and the regulations adopted there- 
under (beginning with Section 66001 of this Title). 
NOTE; Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence; Section 131 1.5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.53. Gases for Medical Use. 

(a) Gases for medical use covered by this section are nonflammable 
medical gases which include, but are not limited to, oxygen, nitrous ox- 
ide, medical compressed air, carbon dioxide, helium, nitrogen and mix- 
tures of such gases when used for medical purposes. 

(b) All medical gas systems including those used for respiratory thera- 
py shall meet the provisions of Section 2-1008, Part 2 of Title 24 of the 
California Administrative Code. 

(c) Provisions shall be made for the safe handling and storage of medi- 
cal gas cylinders. 

(d) Transfer of gas by Institute personnel from one cylinder to another 
shall not be permitted. 

(e) Oxygen equipment. 

(1) Vaporizer bottles on oxygen equipment shall be sterilized after 
each use. 

(2) Only sterile distilled water shall be used in vaporizer bottles 

(3) Vaporizer bottles shall be changed at least every 24 hours. 
NOTE: Authority cited: Sections 1311.5, 1312.7 and 18944, Health and Safety 
Code. Reference: Section 1311.5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



Page 1293 



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§ 97324.55 



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Title 22 



§ 97324.55. Water Supply and Plumbing. 

(a) Where water for human consumption is from an independent 
source, it shall be subjected to bacteriological analysis by the local health 
department or a licensed commercial laboratory at least every three 
months. A copy of the most recent laboratory report shall be available for 
inspection. 

(b) Plumbing and drainage facilities shall be maintained as required by 
Part 5 of Title 24 of the California Administrative Code, Basic Plumbing 
Requirements. Drinking water supplies shall comply with Group 4, Sub- 
chapter 1 , Chapter 5, Division T17, Part 6, of Title 24, California Admin- 
istrative Code. 

(c) Vacuum breakers shall be maintained in operating condition as re- 
quired by Part 5 of Title 24 of the California Administrative Code. 

(d) Hot water temperature controls shall be maintained to automatical- 
ly regulate temperature of hot water delivered to plumbing fixtures used 
by patients to attain a hot water temperature as required by Section 
5-1010, Part 5 of Title 24 of the California Administrative Code. 

(e) Minimum hot water temperature shall be maintained at the final 
rinse section of dishwashing facilities as required by Section Table No. 
5-lOB, Part 5 of Title 24 of the California Administrative Code unless 
alternate methods are approved by the Department. 

(f) Taps delivering water at or above the stated temperatures shall be 
in compliance with requirements specified in Section 5-1010, Part 5 of 
Title 24 of the California Administrative Code. Special precautions shall 
be taken to prevent the scalding of patients. 

(g) Grab bars, readily accessible to patients, shall be maintained at 
each toilet, bathtub and shower used by patients. 

(h) Toilet, handwashing and bathing facilities shall be maintained in 
operating condition and in the number and types specified in construction 
requirements in effect at the time the building or unit was constructed. 
Those handwashing facilities listed in Part 5 of Title 24 of the California 
Administrative Code, shall not be equipped with aerators. 
NOTE: Authority cited: Sections 1311.5, 1312.7 and 18944, Health and Safety 
Code. Reference: Section 1311.5, Health and Safety Code. 

§ 97324.57. Lighting. 

(a) All rooms, attics, basements, passageways, and other spaces shall 
be provided with artificial illumination as required by Parts 2 and 3 of 
Tide 24 of the California Administrative Code. 

(b) All patient rooms shall have a minimum of 30 foot candles of light 
delivered to reading or working surfaces and not less than 20 foot candles 
of light in the rest of the room. 

(c) All accessible areas of corridors, storerooms, stairways, ramps, ex- 
its and entrances shall have a minimum of 2 foot candles of light. 
NOTE: Authority cited: Sections 1311.5, 1312.7 and 18944, Health and Safety 
Code. Reference: Section 1311.5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1 312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.59. Maintenance Manual. 

(a) A written manual on maintenance of heating, air conditioning and 
ventilation systems shall be adopted by each Institute. 

(b) A log shall be utilized to document maintenance work performed. 

(c) When maintenance is performed by an equipment service compa- 
ny, a certification shall be provided to the Institute that the required work 
has been performed in accordance with acceptable standards. This certi- 
fication shall be retained on file in the Institute for review by the Depart- 
ment. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Sections 1311.5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 



§ 97324.61 . Mechanical Systems. 

Heating, air conditioning and ventilating systems shall be maintained 
in normal operating conditions to provide a comfortable temperature and 
shall meet the requirements of Chapter 4-22, Part 4 of Title 24 of the Cali- 
fornia Administrative Code. 

NOTE: Authority cited: Sections 1311.5, 1312.7 and 18944, Health and Safety 
Code. Reference: Section 131 1.5, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87. No. 15). 

§ 97324.63. Screens. 

Screens shall be provided as required by Section 2-I007A, Part 2 of 
Title 24 of the California Administrative Code. 

NOTE; Authority cited: Sections 1311.5, 1312.7 and 18944, Health and Safety 
Code. Reference: Section 1311.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon filing. This section 

was adopted on an interim basis as authorized by Health and Safety Code Sec- 

fion 1312.7 and is repealed by operation of that same secfion effecfive 7-1-90 

(Register 87, No. 15). 

§ 97324.65. Storage. 

Combined general and specialized storage space shall be maintained 
as required by Section 2-lOiOB of Part 2 Title 24 of the California Ad- 
ministrative Code. 

NOTE; Authority cited: Sections 1311.5, 1312.7 and 18944, Health and Safety 
Code. Reference: Section 131 1.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effecfive upon fifing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register87, No. 15). 

§ 97324.67. Construction Variances. 

Applicants wishing to obtain variances from the construction require- 
ments of Division 12.5 (commencing with Section 15000) of the Health 
and Safety Code shall submit their requests on forms provided by the Of- 
fice. 

NOTE: Authority cited: Secfions 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon fifing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97324.69. Recreation and Dining Areas. 

Lounge, recreation and dining areas shall be provided apart from 
sleeping quarters. 

NOTE; Authority cited: Secfions 131 1.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Secfion 131 1.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97324.71 . Nursing Stations. 

(a) Nursing stations shall be maintained in each nursing unit or build- 
ing. 

(b) Nursing stations shall be maintained with a cabinet, a desk, space 
for records, a bulletin board, a telephone and a specifically designated 
and well-illuminated medicine storage compartment with a lockable 
door. If a separate medicine room is maintained, it shall have a lockable 
door and a medicine sink with water connections. If a nourishment refrig- 
erator is used, the following standards shall apply: 

(1) Be located in a clean area not subject to contamination by human 
waste and subject to the same conditions specified in Section 
97321.53(c). 

(2) Maintain temperatures at or below 7°C (45°F) for chilling. 
Have a freezer unit which will maintain the freezer at or below minus 

7°C (20OF). 



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(4) Have a reliable thermometer in refrigerator at all times. 

(5) Food in the refrigerator subject to the same conditions as specified 
in Section 97321.59(d)(6). 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 131 1,5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.73. Disinfecting and Sterilizing. 

Each Institute shall make provision for disinfection of contaminated 
articles or surfaces such as mattresses, linen, thermometers and oxygen 
tanks. 

NOTE: Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.75. Maintenance and Operation. 

(a) The Institute shall be clean, sanitary and in good repair at all times. 

(b) Flashlights shall be in readiness for use at all times. Open flame 
light shall not be used. 

(c) Periodic inspection, testing and calibration of all electrical medical 
equipment shall be made in accordance with the manufacturer's specifi- 
cations, but no less frequently than yearly. Records of such inspections 
and tests shall be retained. 

(d) A Institute may be required to submit a report by a licensed struc- 
tural engineer when the Department has determined that an evaluation of 
the structural condition of the Institute is necessary. Such report shall es- 
tablish the existence or nonexistence of structural conditions which are 
hazardous to occupants and should hazardous conditions exist, such re- 
port shall provide a basis for a plan of correction. 

NOTE: Authority cited: Sections 1311. 5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97324.77. Cleaning Equipment and Fixtures. 

Each Institute shall provide for the cleaning of articles, equipment and 
surfaces such as furniture, walls, exhaust grills and light and plumbing 
fixtures. 

NOTE: Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



Article 6. 



Standards for All Types of 
Services 



§97325.1. Prograrn Flexibility. 

The Director may consider and approve in writing a written proposal 
from an applicant or designee that wishes to use alternative concepts, 
methods, procedures, techniques, equipment or personnel qualifications, 
or conduct pilot projects, while providing safe and adequate care to the 
patient. 

NOTE: Authority cited: Sections 13 1 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon fiUng. This section 

was adopted on an interim basis as authorized by Health and Safety Code Sec- 



tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97325.3. other Departments. 

Participation in the demonstration project does not preclude the Insti- 
tute from participating in programs being conducted by other state de- 
partments. 

NOTE: Authority cited: Sections 1311 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 131 1 .5, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97325.5. Advisory Committee. 

(a) The Institute shall have an Advisory Committee composed of com- 
munity representatives and patients' family members appointed by the 
governing body of the Institute. The Advisory Committee shall meet at 
least quarterly and shall report to the governing body of the Institute. 

(b) The responsibilities of the Advisory Committee shall include but 
not be limited to advising the governing body on: 

(1) Patient care and placement issues. 

(2) The need for services to patients, their families and/or caregivers. 

(3) The need for research and education programs. 

(c) Minutes of each meeting shall be taken and shall reflect policies 
and issues reviewed and decisions reached. 

NOTE: Authority cited: Sections 1311 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1. New secnon filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97325.7. Patient Population. 

The proportion of patients receiving each type of services shall ap- 
proximate the proportion of all patients with Alzheimer's disease and re- 
lated dementias who require that type of services. 
NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97325.9. Conflict Between Regulations Affecting Types 
of inpatient Services. 

If there is a conflict between regulations governing two or more types 
of inpatient services, the regulation requiring a higher level of care shall 
apply. 

NOTE: Authority cited: Sections 131 1.5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 131 1.5, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



Article 7. Monitoring and Compliance 

§ 97326.1 . Access to Records and Facility Sites. 

Any duly authorized officer, employee, or agent of the Department or 
the Office may, upon presentation of proper identification, enter and in- 
spect any building or premises, and inspect any records of the Institute, 
or enter and inspect any physical setting where patients receive care from 
a provider under contract or other written agreement with the Institute 
and inspect the records of those patients, at any reasonable time to secure 
compliance with, or to prevent a violation of, the provisions of Chapter 
22, Statutes of 1986 (Health and Safety Code Sections 1310 et seq.) and 
this Chapter. 



Page 1295 



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Title 22 



NOTE; Authority cited: Sections 1 31 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 131 1.2, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87. No. 15). 

§ 97326.3. Inspection of Institutes and/or Other Providers 
of Care. 

(a) All Institutes which have been designated by the Office shall be in- 
spected periodically by a representative or representatives of the Depart- 
ment, Office and/or other state department. 

(b) Inspections shall be conducted as frequently as necessary but not 
less than once each year to assure that quality care is being provided. Dur- 
ing the inspection, the representative or representatives of the Depart- 
ment, Office or other State departments shall offer such advice and assis- 
tance to the Institute as is appropriate. 

NOTE: Authority cited: Sections 13 1 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 131 1.2, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97326.5. Consultation. 

The Department may provide consulting services upon request to any 
Institute to assist in the identification or correction of deficiencies or the 
upgrading of the quality of care provided by the Institute. 
NOTE: Authority cited: Sections 1 3 1 1 .5 and 13 1 2.7, Health and Safety Code. Ref- 
erence: Section 131 1.2, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1 312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97326.7. Notice of Deficiencies. 

The Department shall notify the Institute of all deficiencies of com- 
pliance with this Chapter and the Institute shall agree with the Depart- 
ment upon a plan of corrections which will give the Institute a reasonable 
time to correct such deficiencies. 

NOTE: Authority cited: Sections 131 1.5 and 131 2.7, Health and Safety Code. Ref- 
erence: Section 131 1.2, Health and Safety Code. 

History 
I . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97326.9. Follow-up Visit. 

(a) A follow-up visit will be made no later than 30 days after an inspec- 
tion visit which resulted in a notice of deficiencies. 

(b) If at the end of the allotted time, as revealed by repeat inspections, 
the Institute has failed to correct the deficiencies, the Department may 
recommend to the Office and the Director that designation of the Institute 
be withdrawn in whole or in part or suspended. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Secfion 131 1.2, Health and Safety Code. 

History 
1. New section filed 4-6-87 as an emergency; effective upon filing. This secfion 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operafion of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97326.1 1 . Reasons for Suspending/Withdrawing 
Demonstration Project Designation. 

The Office may suspend or withdraw, in whole or in part, demonstra- 
tion project designation for any of the following reasons: 

(a) On its own motion for any violation of the designation agreement. 

(b) On the motion of the Department of Health Services for (1 ) a viola- 
tion of the provisions of Chapter 22, Statutes of 1986 (Health and Safety 



Code Section 1 3 10 et seq.) and this Chapter; (2) aiding, abetting, or per- 
mitting the violation of any provisions of Chapter 22, Statutes of 1986 
(Health and Safety Code Section 1310 et seq.) and this Chapter; (3) con- 
duct inimical to the public health, morals, welfare, or safety of the people 
of the State of California in the maintenance and operation of the prem- 
ises or services for which Alzheimer's Disease Institute designation was 
given, or the premises or services of a provider which has a contract or 
other written agreement with the Institute to provide services or care to 
Institute patients. 

NOTE: Authority cited: Sections 1311 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1311.2, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
fion 1312.7 and is repealed by operation of that same secfion effective 7-1-90 
(Register 87, No. 15). 

§ 97326.13. Methods of Withdrawing or Suspending 
Demonstration Project Designation. 

(a) The Office may withdraw or suspend, in whole or in part, demon- 
stration project designation by the service of an accusation upon an au- 
thorized representative of an Institute. The accusation shall state facts 
that give rise to the withdrawal or suspension. The withdrawal or suspen- 
sion shall take effect 30 calendar days after receipt of service, unless the 
Institute requests a hearing pursuant to subdivision (b) of this section. 

(b) If an Institute wants to contest a withdrawal or suspension, in whole 
or in part, of its demonstration project designation, it may request an ad- 
ministrative hearing. A request for an administrative hearing shall be 
mailed to the Director of the Office by certified mail, return receipt re- 
quested, within 20 calendar days of receipt of the accusation. The Office 
Director shall then cause a hearing to be held within 30 calendar days af- 
ter receipt of the request for hearing. 

(c) The Director of the Office may temporarily suspend, in whole or 
in part, demonstration project designation without the right to a prior ad- 
ministrative hearing when in the Director's opinion such action is neces- 
sary to protect the public health and safety. The Director of the Office 
shall notify an authorized representative of an Institute of the effective 
date of a temporary suspension by service of an accusation which clearly 
states that it includes a temporary suspension. The temporary suspension 
shall remain in effect until conclusion of the administrative hearing pro- 
cess described in Section 97326.15, if an administrative hearing is re- 
quested. At the conclusion of the administrative hearing process the tein- 
porary suspension shall either be lifted in its entirety, modified or made 
permanent. If no administrative hearing is requested, the temporary sus- 
pension shall remain in effect until the Director determines whether the 
temporary suspension shall be lifted in its entirety, modified or made per- 
manent. 

NOTE; Authority cited: Sections 131 1 .5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1311.2, Health and Safety Code. 

History 

1. New secfion filed 4-6-87 as an emergency; effecfive upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same secfion effecfive 7-1-90 
(Register 87, No. 15). 

§97326.15. Hearing Procedure. 

(a) The hearing shall be held by an employee of the Office delegated 
the responsibility to conduct the hearing by the Director of the Office.The 
formal rules of evidence shall not apply except that all testimony shall be 
sworn. An Institute may but need not be represented by counsel. 

The hearing will be taped recorded by the Office. The Institute may 
bring a certified shorthand reporter instead, if it agrees to provide the Of- 
fice with a copy of the transcript at no charge. The hearing shall proceed 
as follows: 

(1) One or more representatives of the Office or the Department of 
Health Services shall present the evidence that was the basis for the accu- 
sation. 

(2) The Institute through its authorized representatives shall be given 
its opportunity to present its side of the case. 



Page 1296 



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§ 97333.3 



(3) Both parties shall summarize their respective positions. 

(4) The case shall then be submitted to the hearing officer for a pro- 
posed decision. 

(b) The hearing officer shall prepare a Proposed Decision with find- 
ings of fact and conclusions of law for submittal to the Director within 
10 calendar days of the conclusion of the hearing. 

(c) The Director shall then have 10 calendar days to adopt or reject the 
Proposed Decision. 

(d) If the Director does not adopt the Proposed Decision, he or she will 
furnish a Notice of Rejection of Proposed Decision along with a copy of 
the Proposed Decision to the Institute through the Institute's authorized 
representative. The Director will provide the Institute the opportunity to 
present written arguments to the Office within a reasonable period of 
time. The Director may also provide the Institute an opportunity to pres- 
ent additional oral arguments before the Office The decision of the Direc- 
tor will be based on the record, including the hearing record, and such ad- 
ditional information as is provided by the Institute. The decision of the 
Office shall be made within 30 calendar days of the rejection of the Pro- 
posed Decision. 

(e) The decision of the Director shall be final upon service of a copy 
of the decision on an authorized representative of the Institute. 

NOTE: Authority cited: Sections 1311,5, 1312.7 and 18944, Health and Safety 

Code. Reference: Section 131 1.2, Health and Safety Code. 

HtSTORY 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



Subchapter 3. Skilled Nursing Services 



Article 1. Definitions 



§ 97331 .1 . Administrator. 

Administrator means the program administrator, a person licensed as 
a nursing home administrator by the California Board of Nursing Home 
Administrators who has been appointed in writing, and who has responsi- 
bility for the operation of the Skilled Nursing Services Unit of the Insti- 
tute and for all patients receiving care in that unit. 

NOTE; Authority cited: Sections 1311.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§97331.3. Director. 

Director means the director of the California Department of Health 
Services. 

NOTE: Authority cited: Sections 1311 .5 and 13 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97331 .5. Nursing Service. 

Nursing service means a service staffed, organized and equipped to 
provide skilled nursing care to patients on a continuous basis. 
NOTE: Authority cited: Sections 1 3 1 1 .5 and 13 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312.3, Health and Safety Code. 

History 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



§ 97331 .7. SIcilled Nursing Services Unit. 

Skilled Nursing Services Unit means that distinct part or area or areas 
of the Institute where skilled nursing care services are provided to pa- 
tients. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safely Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



Article 2. Designation 

§97332.1. Designation. 

A designated Institute shall not need a separate license for the provi- 
sion of skilled nursing care. 

NOTE: Authority cited: Sections 131 1 .5 and 1 312.7, Health and Safety Code. Ref- 
erence: Section 1312.3, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 



Article 3. Required Services 

§ 97333.1 . Required Services. 

(a) The Skilled Nursing Services Unit shall provide, but shall not be 
Hmited to, the following required services: physician, skilled nursing, di- 
etary, pharmaceufical and an acfivity program. 

(b) Written arrangements shall be made for obtaining all necessary 
diagnostic and therapeutic services prescribed by the patient's attending 
physician, subject to the policies of the Institute. If the service cannot be 
brought into the Institute, the Institute shall assist the patient in arranging 
for transportafion to and from the service location. 

(c) Arrangements shall be made for an advisory dentist to participate 
at least annually in he staff development program for all patient care per- 
sonnel and to approve oral hygiene policies and practices for the care of 
patients. 

(d) The Insfitute shall ensure that all orders, written by a person lawful- 
ly authorized to prescribe, shall be carried out unless contraindicated. 

(e) The Institute shall make arrangements for a physician or physicians 
to be available to furnish emergency medical care if the attending physi- 
cian or designee is unavailable. The telephone numbers of those physi- 
cians shall be posted in a conspicuous place in the Skilled Nursing Ser- 
vices Unit. 

Note: Authority cited: Sections 1 311 .5 and 1312.7, Health and Safety Code Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1. New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97333.3. Nonphysician Practitioners. 

(a) Nonphysician practitioners may be permitted to render those medi- 
cal services which they are legally authorized to perform. Nonphysician 
practitioners means any of the following: 

(1) Physicians' assistants working under the responsibility and super- 
vision of a physician approved as a supervisor by the Board of Medical 
Quality Assurance and performing only those selected diagnostic and 
therapeutic tasks identified in Chapter 13, Subchapter3, Articles of Title 
16 of the California Administrative Code. 

(2) Registered nurses may perform patient care services utilizing 
"Standardized Procedures" wliich have been approved by the medical 
staff, or by the medical director if there is no organized medical staff, the 
registered nurse and the administrator as authorized in Section 2725, Di- 
vision 2, Chapter 6, Article 2 of the Business and Professions Code. 



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Title 22 



NOTE: Authority cited: Sections 1 31 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 

1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 1 5). 

§ 97333.5. Physician Services — Supervision of Care. 

(a) Each patient assigned to the Skilled Nursing Services Unit shall be 
under the continuing supervision of a physician who evaluates the patient 
as needed and at least every 30 days unless there is an alternate schedule, 
and who documents the visits in the patient's Unit health record. 

(b) Alternate schedules of visits shall be documented in the patient's 
Unit health record with a medical justification by the attending physician. 
The alternate schedule shall conform with Institute policy. 

NOTE: Authority cited: Sections 131 1.5 and 1312.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 

History 
1. New section filed 4—6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97333.7. Nursing Service — General. 

(a) Nursing service shall include, but not be limited to, the following: 

(1 ) Planning of patient care, which shall include at least the following: 

(A) Identification of care needs and development of an individual plan 
of care based upon the patient's treatment and inanagement plan and on 
assessment of the patient's needs by the case manager and nursing staff. 
Initial assessments shall commence at the time of admission of the patient 
and be completed within seven days after development of the treatment 
and management plan. 

(B) Development of an individual, written nursing care plan which in- 
dicates the nursing care to be given and the objectives to be accom- 
plished. Objectives shall be measurable and time-limited. 

(C) Reviewing, evaluating and updating of the nursing care plan each 
time the treatment and management plan is revised and as necessary by 
the nursing staff and the case manager at least quarterly, and more often 
if there is a change in the patient's condition. 

(2) Implementing of each patient's nursing care plan according to the 
methods indicated. Each patient's nursing care shall be based on this 
plan. 

(3) Notifying the attending physician promptly of: 

(A) Any sudden and/or marked change in signs, symptoms or behavior 
exhibited by a patient. 

(B) Any unusual occurrence involving a patient, as defined in Section 
97323.15. 

(C) A change in weight of five pounds or more within a 30-day period 
unless a different stipulation has been slated in writing by the patient's 
physician. 

(D) Any untoward response or reaction by a patient to a medication or 
treatment. 

(E) Any error in the administration of a medication or treatment to a 
patient which is life threatening and presents a risk to the patient. 

(F) The Unit' s inability to obtain or administer, on a prompt and timely 
basis, drugs, equipment, supplies or services as prescribed under condi- 
tions which present a risk to the health, safety or security of the patient. 

(b) All attempts to notify physicians shall be noted in the patient's Unit 
health record including the time and method of communication and the 
name of the person acknowledging contact, if any. If the attending physi- 
cian or their designee is not readily available, emergency medical care 
shall be provided as outlined in Section 97333.1. 

(c) Licensed nursing personnel shall ensure that patients are served the 

diets as prescribed by attending physicians. 

NOTE: Authority cited: Sections 13 1 1 .5 and 1 3 1 2.7, Health and Safety Code. Ref- 
erence: Section 1312, Health and Safety Code. 



HfSTORY 
1 . New section filed 4-6-87 as an emergency; effective upon filing. This section 
was adopted on an interim basis as authorized by Health and Safety Code Sec- 
tion 1312.7 and is repealed by operation of that same section effective 7-1-90 
(Register 87, No. 15). 

§ 97333.9. Nursing Service — Administration of 
iVIedications and Treatments. 

(a) Medications and treatments shall be administered as follows: 

( 1 ) No medication or treatment shall be administered except on the or- 
der of a person lawfully authorized to give such order. 

(2) Medications and treatments shall be administered as prescribed. 

(3) Tests and taking of vital signs, upon which administration of medi- 
cations or treatments are condirioned, shall be performed as required and 
the results recorded. 

(4) Preparation of doses for more than one scheduled administrauon 
tiine shall not be permitted. 

(5) All medications and treatments shall be administered only by li- 
censed medical or licensed nursing personnel with the following excep- 
tions: 

(A) Students in the heahng arts professions may administer inedica- 
tions and treatments only when the administration of medications and 
treatments is incidental to their course of study as approved by the profes- 
sional board or organization legally authorized to give such approval. 

(B) Unlicensed persons may, under the direct supervision of hcensed 
nursing or licensed medical personnel, during training or after comple- 
tion of training and demonstrated evidence of competence, administer 
the following; 

1. Medicinal shampoos and baths. 

2. Laxative suppositories and laxative enemas. 

3. Nonlegend topical ointments, creams, lorions and solutions when 
applied to intact skin surfaces. Unhcensed persons shall not administer 
any medication associated with treatment of eyes, ears, nose, mouth, or 
genitourinary tract. 

(6) Medications shall be administered as soon as possible, but no more 
than two hours after doses are prepa